Pandemic spread of blaKPC-2 among Klebsiella pneumoniae ST11 in China is associated with horizontal transfer mediated by IncFII-like plasmids
Pandemic spread of blaKPC-2 among Klebsiella pneumoniae ST11 in China is associated with horizontal transfer mediated by IncFII-like plasmids
复制标题
blaKPC-2 在中国肺炎克雷伯菌 ST11 中的大流行与 IncFII 样质粒介导的水平转移有关
DOI：
10.1016/j.ijantimicag.2019.03.014
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发表时间：
2019-08-01
影响因子：
10.8
通讯作者：
Jiang, Xiaofei
中科院分区：
文献类型：
--
作者：
Fu, Pan;Tang, Yu;Jiang, Xiaofei
目的：了解肺炎克雷伯菌中blA(kpc-2)基因的传播情况，探讨产碳青霉烯酶肺炎克雷伯菌(kpc-KP)ST11在中国的传播机制。用移动遗传元件(MGES)和脉冲场凝胶电泳法(PFGE)鉴定肺炎克雷伯菌ST11亚型。聚合酶链式反应(PCR)扩增和测序分析Tn1721转座子和IncFII样质粒。结果：肺炎克雷伯菌以KPC-KP为主(87.1%)，在非KPC-KP中不占优势(3.1%)。ST11KPC-KP具有克隆性异质性，可进一步划分为11个MGE类型和14个PFGE亚型。在IncFII样质粒上发现了5个Tn1721-bla(KPC-2)变异体。ST11 KPC-KP组IncFII样质粒的检出率(100%)明显高于非ST11 KPC-KP组(16.0%)和非KPC-KP组(7.5%)。此外，在MGE-F型(61.7%)上初步检测到含有IIa复制子的IncFII质粒。带有IIK复制子的IncFIIk质粒可分为两个亚型：MGE-A(28.3%)和-F(41.5%)。在MGE-A上检测到IncFII和IncFIIk的阳性率分别为57.1%(20/35)和42.9%(15/35)。结论：ST11 KPC-KP与IncFII样质粒密切相关。IncFII样质粒介导的水平转移在中国肺炎克雷伯菌ST11中BLA(Kpc-2)的流行扩展中起着重要作用。(C)2019年爱思唯尔公司和国际化疗学会。版权所有。
Objectives: The aim of this study was to investigate the spread of the bla(KPC-2) gene among Klebsiella pneumoniae and to illustrate the mechanism of dissemination of K. pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) ST11 in China.Methods: A total of 354 K. pneumoniae isolates were collected from four hospitals in China and were characterized by multilocus sequence typing (MLST). Mobile genetic elements (MGEs) and pulsed-field gel electrophoresis (PFGE) analysis were used to identify the subtypes of K. pneumoniae ST11. Polymerase chain reaction (PCR)-based amplification and sequencing were performed to analyse Tn1721 transposons and IncFII-like plasmids. Electroporation experiments and whole-genome sequencing (WGS) were used to reveal the genetic environment of the bla(KPC-2) gene.Results: As the primary type (87.1%) of KPC-Kp, K. pneumoniae ST11 was not predominant in non-KPC-Kp (3.1%). ST11 KPC-Kp was clonally heterogeneous and could be further classified into 11 MGE types and 14 PFGE subtypes. Five Tn1721-bla(KPC-2) variants were identified on IncFII-like plasmids. The detection rate of IncFII-like plasmids was much higher in ST11 KPC-Kp (100%) compared with non-ST11 KPC-Kp (16.0%) and the non-KPC-Kp group (7.5%). Moreover, the IncFII plasmid (with IIa replicon) was primarily detected on the MGE-F type (61.7%). The IncFIIk plasmid (with IIk replicon) was clustered into two subtypes: MGE-A (28.3%) and -F (41.5%). The detection of the IncFII and IncFIIk plasmids on MGE-A was 57.1% (20/35) and 42.9% (15/35), respectively.Conclusions: A close correlation was shown between ST11 KPC-Kp and IncFII-like plasmids. Horizontal transfer mediated by IncFII-like plasmids plays an important role in the pandemic expansion of bla(KPC-2) among K. pneumoniae ST11 in China. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.