Dissemination of IncFIIK-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from children in hospital paediatric oncology wards
Dissemination of IncFIIK-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from children in hospital paediatric oncology wards
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DOI：
10.1016/j.ijantimicag.2012.07.016
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发表时间：
2012-12-01
影响因子：
10.8
通讯作者：
Sterba, Jaroslav
中科院分区：
文献类型：
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作者：
Dolejska, Monika;Brhelova, Eva;Sterba, Jaroslav
在这项研究中，超广谱β-内酰胺酶（ESBL）生产肠杆菌科分离株的恶性肿瘤住院儿童在儿科肿瘤科在捷克共和国进行了调查。2009年6月至2010年1月，从28名患者中共获得50株产ESBL的肠杆菌科粪便分离株。这些菌株的特点是关于ESBL酶，质粒介导的喹诺酮类耐药基因，多位点序列分型（MLST）和质粒赋予耐头孢菌素和氟喹诺酮类。产ESBL菌株包括肺炎克雷伯菌（36株）、大肠埃希菌（7株）、产酸克雷伯菌（3株）、阴沟肠杆菌（2株）和弗氏柠檬酸杆菌（2株）。肺炎克雷伯菌分离株属于7个MLST型，包括序列型ST 280、ST 321、ST 323和ST 416以及新类型ST 626、ST 627和ST 628。多抗性流行克隆E.大肠杆菌B2-O25 b-ST 131。在大多数分离株中，在大型接合性IncPHI（K）质粒上发现了基因bla（CTX-M-15）以及bla（TEM-1）、bla（OXA-1）、qnrB 1、aac（6 '）-Ib-cr、strA、sul 2、aac（3'）-II和泰特（A）基因。IncFII（K）质粒在各种肠杆菌科分离株中的传播被认为是产ESBLs肠杆菌科菌种在病房中医院定殖的重要方面。这是第一项研究记录了在单个医院部门分离的各种细菌物种中IncFII（K）质粒中的多种抗生素耐药元件，包括qnr基因。结果强调了IncFII（K）质粒演变为含有新型抗生素耐药元件的新变体，以及它们在住院患者中传播产ESBL细菌的重要作用。(c)2012年爱思唯尔B。和国际化疗学会。All rights reserved.
In this study, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae isolates in children with malignancies hospitalised at a paediatric oncology department in the Czech Republic were investigated. From June 2009 to January 2010, a total of 50 ESBL-producing faecal isolates of Enterobacteriaceae were obtained from 28 patients. These isolates were characterised with regard to ESBL enzymes, plasmid-mediated quinolone resistance genes, multilocus sequence typing (MLST) and plasmids conferring resistance to cephalosporins and fluoroquinolones. ESBL-producing isolates included Klebsiella pneumoniae (n = 36), Escherichia coli (n = 7), Klebsiella oxytoca (n = 3), Enterobacter cloacae (n = 2) and Citrobacter freundii (n = 2). Klebsiella pneumoniae isolates belonged to 7 MLST types, including sequence types ST280, ST321, ST323 and ST416 as well as the novel types ST626, ST627 and ST628. The multiresistant epidemic clone E. coli B2-O25b-ST131 was detected in one patient. The gene bla(CTX-M-15) was found on large conjugative IncFII(K) plasmids along with bla(TEM-1), bla(OXA-1), qnrB1, aac(6')-Ib-cr, strA, sul2, aac(3')-II and tet(A) genes in most isolates. Dissemination of IncFII(K) plasmids among various Enterobacteriaceae isolates was considered an important aspect of nosocomial colonisation in the wards by Enterobacteriaceae species producing ESBLs. This is the first study documenting multiple antibiotic resistance elements, including qnr genes, in IncFII(K) plasmids in various bacterial species isolated in a single hospital department. The results highlight the evolution of IncFII(K) plasmids into new variants containing novel antibiotic resistance elements and their important role in spreading ESBL-producing bacteria among hospitalised patients. (c) 2012 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.