Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses
Outbreak of KPC-producing Klebsiella pneumoniae ST15 strains in a Chinese tertiary hospital: resistance and virulence analyses
复制标题
中国三级医院爆发产 KPC 肺炎克雷伯菌 ST15 菌株：耐药性和毒力分析
DOI：
10.1099/jmm.0.001494
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发表时间：
2022-01-01
影响因子：
3
通讯作者：
Zhao, Zhigang
中科院分区：
文献类型：
--
作者：
Huang, Jiansheng;Chen, Xiuying;Zhao, Zhigang
导论.耐碳青霉烯类肺炎克雷伯菌（CRKP）是临床感染的主要原因。然而，K.产碳青霉烯酶（KPC）的肺炎克雷伯氏菌（K.肺炎链球菌ST 15菌株偶尔被发现，在中国很少报告引起医院爆发。假设/差距声明。在这项研究中，我们描述了医院暴发所造成的KPC生产的K。肺炎链球菌ST 15株的临床研究。研究32株KPC产生菌的分子亲缘关系、抗性及毒力因子。肺炎链球菌ST 15菌株的分离。2018年从中国一家三级医院共收集了102株非重复碳青霉烯类耐药肠杆菌科（CRE）菌株。采用多位点序列分型（MLST）和脉冲场凝胶电泳（PFGE）技术分析K. pneumoniae分离株，并选择ST 15菌株用于进一步研究。使用肉汤微量稀释法测定最低抑菌浓度（MIC），并根据临床和实验室标准协会（CLSI）指南进行解释。PCR检测了15个碳青霉烯类耐药基因、bla（KPC）基因结构和12个毒力因子。采用新一代测序技术结合单分子实时测序技术进行全基因组测序。三万二千pneumoniae ST 15菌株的特征，其中31株呈现> 92%的PFGE相似性，表明克隆扩散。在81.3%（26/32）的菌株中，亚胺培南（IPM）和美罗培南（MEM）的MIC
Introduction. Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of clinical infection. However, K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae ST15 strains are occasionally identified and have seldom been reported to cause hospital outbreaks in PR China.Hypothesis/Gap Statement. In this study, we describe nosocomial outbreaks caused by KPC-producing K. pneumoniae ST15 strains in a Chinese tertiary hospital.Aim. To characterize the molecular relationship, resistance and virulence factors of the 32 KPC-producing K. pneumoniae ST15 strains isolated in a Chinese hospital.Methodology. A total of 102 non-repetitive carbapenem-resistant Enterobacteriaceae (CRE) strains were collected from a Chinese tertiary hospital in 2018. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were performed to characterize the clonal relationship of the K. pneumoniae isolates, and the ST15 strains were selected for further study. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Fifteen carbapenem resistance genes, bla(KPC) genetic structures and 12 virulence factors were detected by PCR. Whole-genome sequencing (WGS) was performed using next-generation sequencing combined with single-molecule real-time sequencing.Results. Thirty-two K. pneumoniae ST15 strains were characterized, and 31 of them presented a PFGE similarity of >92%, indicating clonal spread. In 81.3% (26/32) of strains, the imipenem (IPM) and meropenem (MEM) MICs were