Genomic Surveillance of Carbapenem-Resistant Klebsiella pneumoniae from a Major Public Health Hospital in Singapore.
Genomic Surveillance of Carbapenem-Resistant Klebsiella pneumoniae from a Major Public Health Hospital in Singapore.
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新加坡一家主要公共卫生医院碳青霉烯类耐药肺炎克雷伯菌的基因组监测。
DOI：
10.1128/spectrum.00957-22
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发表时间：
2022-10-26
影响因子：
3.7
通讯作者：
Ong, Rick Twee-Hee
中科院分区：
文献类型：
--
作者：
Teo, Jocelyn Qi-Min;Tang, Cheng Yee;Tan, Si Hui;Chang, Hong Yi;Ong, Sze Min;Lee, Shannon Jing-Yi;Koh, Tse-Hsien;Sim, James Heng-Chiak;Kwa, Andrea Lay-Hoon;Ong, Rick Twee-Hee
关键词：
耐碳青霉烯肺炎克雷伯菌（CRKP）是全球公共卫生威胁。在这项研究中，我们采用全基因组测序（WGS）来确定从新加坡一家大型公立急症医院回收的临床CRKP分离株的纵向收集的基因组流行病学。对2009年至2020年间收集的575株独特的CRKP分离株进行了系统发育分析、抗性和毒力决定因素的表征以及质粒谱分析。系统发育分析发现，在CRKP群体中存在全局高危克隆（克隆群[CG] 14/15、CG17/20、CG147、CG258和序列型[ST] 231），这些克隆占分离株的50%。产碳青霉烯酶常见（n = 497, 86.4%），以KPC酶为主（n = 235, 40.9%），其次为oxa -48样酶（n = 128, 22.3%）和NDM酶（n = 93, 16.2%）。在59株（10.3%）分离株中检测到高毒力，其中产碳青霉烯酶ST231分离株最常见（21/59,35.6%）。碳青霉烯酶基因与多种质粒复制子相关；然而，blaOXA-181/232与ColKP3质粒存在关联。本研究提出了在新加坡流行的CRKP菌株的复杂和多样化的流行病学。我们的研究强调了基于wgs的基因组监测在追踪CRKP种群动态中的效用。在这项研究中，我们利用全基因组测序技术对新加坡最大的公立急症医院12年来收集的碳青霉烯耐药肺炎克雷伯菌临床分离株进行了鉴定。这项研究的结果显示了显著的基因组多样性，在不同的非流行病谱系中存在着众所周知的流行病，多药耐药克隆。基因组监测包括综合耐药性、毒力和质粒基因含量分析，为抗菌素耐药性监测提供了关键信息，并强调了未来的监测重点，如ST231肺炎克雷伯菌菌株的多药耐药、毒力元件的出现，以及blaoxa -48样基因的潜在质粒介导传播。本研究结果还强调了考虑到本地流行菌株基因组多样性的独特感染控制和预防策略的必要性。
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a global public health threat. In this study, we employed whole-genome sequencing (WGS) to determine the genomic epidemiology of a longitudinal collection of clinical CRKP isolates recovered from a large public acute care hospital in Singapore. Phylogenetic analyses, a characterization of resistance and virulence determinants, and plasmid profiling were performed for 575 unique CRKP isolates collected between 2009 and 2020. The phylogenetic analyses identified the presence of global high-risk clones among the CRKP population (clonal group [CG] 14/15, CG17/20, CG147, CG258, and sequence type [ST] 231), and these clones constituted 50% of the isolates. Carbapenemase production was common (n = 497, 86.4%), and KPC was the predominant carbapenemase (n = 235, 40.9%), followed by OXA-48-like (n = 128, 22.3%) and NDM (n = 93, 16.2%). Hypervirulence was detected in 59 (10.3%) isolates and was most common in the ST231 carbapenemase-producing isolates (21/59, 35.6%). Carbapenemase genes were associated with diverse plasmid replicons; however, there was an association of blaOXA-181/232 with ColKP3 plasmids. This study presents the complex and diverse epidemiology of the CRKP strains circulating in Singapore. Our study highlights the utility of WGS-based genomic surveillance in tracking the population dynamics of CRKP. IMPORTANCE In this study, we characterized carbapenem-resistant Klebsiella pneumoniae clinical isolates collected over a 12-year period in the largest public acute-care hospital in Singapore using whole-genome sequencing. The results of this study demonstrate significant genomic diversity with the presence of well-known epidemic, multidrug-resistant clones amid a diverse pool of nonepidemic lineages. Genomic surveillance involving comprehensive resistance, virulence, and plasmid gene content profiling provided critical information for antimicrobial resistance monitoring and highlighted future surveillance priorities, such as the emergence of ST231 K. pneumoniae strains bearing multidrug resistance, virulence elements, and the potential plasmid-mediated transmission of the blaOXA-48-like gene. The findings here also reinforce the necessity of unique infection control and prevention strategies that take the genomic diversity of local circulating strains into consideration.
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影响因子：
3.9
作者：
Follador R;Heinz E;Wyres KL;Ellington MJ;Kowarik M;Holt KE;Thomson NR
通讯作者：
Thomson NR
影响因子：
11.8
作者：
Chen, Yahua;Marimuthu, Kalisvar;Gan, Yunn-Hwen
通讯作者：
Gan, Yunn-Hwen
影响因子：
4.9
作者：
Cuzon, Gaelle;Ouanich, Jocelyne;Nordmann, Patrice
通讯作者：
Nordmann, Patrice
DOI：
10.1016/j.ijantimicag.2021.106456
发表时间：
2022-01-11
影响因子：
10.8
作者：
Arca-Suarez, Jorge;Rodino-Janeiro, Bruno K.;Bou, German
通讯作者：
Bou, German
影响因子：
4.9
作者：
Carrer, Amelie;Poirel, Laurent;Nordmann, Patrice
通讯作者：
Nordmann, Patrice