Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2
Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2
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DOI：
10.1093/jac/dkx325
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发表时间：
2017-12-01
影响因子：
5.2
通讯作者：
Oteo, Jesus
中科院分区：
文献类型：
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作者：
Arana, David M.;Ortega, Adriana;Oteo, Jesus
目的：关于产碳青霉烯酶（CP）柠檬酸杆菌属的信息很少。我们研究了CP柠檬酸杆菌的分子流行病学和微生物学特征。方法：共分析了119株根据EUCAST筛选临界值疑似为CP的分离株。碳青霉烯酶和超广谱β-内酰胺酶的特征采用PCR和测序。结果：119株弗氏柠檬酸杆菌中，63株（52.9%）产碳青霉烯酶，其中Vim-1型37株（58.7%），OXA-48型20株（31.7%），KPC-2型12株（19%），NDM-1型2株（3.2%），VIM-2型1株（1.6%）;弗氏分离物共产生Vim-1和OXA-48。14株（22.2%）同时携带ESBLs，其中8株CTX-M-9 + SHV-12，2株CTX-M-9，2株SHV-12和2株CTX-M-15。57株（90.5%）为C.克氏柠檬酸杆菌4株（6.3%），琥珀酸柠檬酸杆菌1株（1.6%），布氏柠檬酸杆菌1株（1.6%）。根据EUCAST折点，8株（12.7%）CP分离株对检测的4种碳青霉烯类药物敏感。在53 CP C.结果表明，在10种Freundii菌中，共观察到44种不同的带型。共鉴定出4个PFGE簇：簇1包括8株同时产生Vim-1和OXA-48的分离株; bla（Vim-1）携带在1类整合子（intI-bla（Vim-1）-aacA 4-dfrB 1-aadA 1-catB 2-qacE Delta 1/sul 1）中，bla（OXA-48）携带在Tn1999.2转座子中。分布在西班牙的几个地理区域。柠檬酸杆菌属4种。产生多达五种碳青霉烯酶类型，包括Vim-1和OXA-48的共同产生。一些CP柠檬酸杆菌属分离株对所测试的四种碳青霉烯类敏感，这一发现具有潜在的临床意义。
Objectives: There is little information about carbapenemase-producing (CP) Citrobacter spp. We studied the molecular epidemiology and microbiological features of CP Citrobacter spp. isolates collected in Spain (2013-15).Methods: In total, 119 isolates suspected of being CP by the EUCAST screening cut-off values were analysed. Carbapenemases and ESBLs were characterized using PCR and sequencing. The genetic relationship among Citrobacter freundii isolates was studied by PFGE.Results: Of the 119 isolates, 63 (52.9%) produced carbapenemases, of which 37 (58.7%) produced VIM-1, 20 (31.7%) produced OXA-48, 12 (19%) produced KPC-2, 2 (3.2%) produced NDM-1 and 1 (1.6%) produced VIM2; 9 C. freundii isolates co-produced VIM-1 plus OXA-48. Fourteen isolates (22.2%) also carried ESBLs: 8 CTX-M-9 plus SHV-12, 2 CTX-M-9, 2 SHV-12 and 2 CTX-M-15. Fifty-seven isolates (90.5%) were C. freundii, 4 (6.3%) were Citrobacter koseri, 1 (1.6%) was Citrobacter amalonaticus and 1 (1.6%) was Citrobacter braakii. By EUCAST breakpoints, eight (12.7%) of the CP isolates were susceptible to the four carbapenems tested. In the 53 CP C. freundii analysed by PFGE, a total of 44 different band patterns were observed. Four PFGE clusters were identified: cluster 1 included eight isolates co-producing VIM-1 and OXA-48; bla(VIM-1) was carried in a class 1 integron (intI-bla(VIM-1)-aacA4-dfrB1-aadA1-catB2-qacE Delta 1/sul1) and bla(OXA-48) was carried in a Tn1999.2 transposon.Conclusions: We observed the clonal and polyclonal spread of CP Citrobacter spp. across several Spanish geographical areas. Four species of Citrobacter spp. produced up to five carbapenemase types, including coproduction of VIM-1 plus OXA-48. Some CP Citrobacter spp. isolates were susceptible to the four carbapenems tested, a finding with potential clinical implications.