New Delhi metallo-β-lactamase-producing Enterobacteriaceae, United States.

New Delhi metallo-β-lactamase-producing Enterobacteriaceae, United States.
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DOI:
10.3201/eid1906.121515
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发表时间:
2013-06
影响因子:
11.8
通讯作者:
Limbago BM
Limbago BM
中科院分区:
医学2区
文献类型:
--
作者:
Rasheed JK;Kitchel B;Zhu W;Anderson KF;Clark NC;Ferraro MJ;Savard P;Humphries RM;Kallen AJ;Limbago BM

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我们对2009年4月至2011年3月期间从美国5个州的8名患者身上培养的9株新德里产金属β-内酰胺酶肠杆菌科(5株肺炎克雷伯菌,2株大肠杆菌,1株阴沟肠杆菌,1株Senftenberg血清型肠沙门氏菌)进行了鉴定。菌株对β-内酰胺类、氟喹诺酮类和氨基糖苷类耐药,黏菌素和多粘菌素mic≤1µg/mL,金属β-内酰胺酶筛选结果阳性。8株分离物有blaNDM-1, 1株分离物有一个新的等位基因(blaNDM-6)。所有8名患者最近都去过印度或巴基斯坦,其中6人接受了住院保健。携带blaNDM的质粒通常携带AmpC或扩展谱β-内酰胺酶基因。两株肺炎克雷伯菌分离株和一株来自瑞典的肺炎克雷伯菌分离株具有不相容的a /C组质粒,具有难以区分的限制性结构和共同的blaNDM片段;3例均为14型多位点序列。其余的新德里金属β-内酰胺酶质粒(包括来自同一患者的2个质粒)的限制性谱不同。
We characterized 9 New Delhi metallo-β-lactamase–producing Enterobacteriaceae (5 Klebsiella pneumoniae, 2 Escherichia coli, 1 Enterobacter cloacae, 1 Salmonella enterica serovar Senftenberg) isolates identified in the United States and cultured from 8 patients in 5 states during April 2009–March 2011. Isolates were resistant to β-lactams, fluoroquinolones, and aminoglycosides, demonstrated MICs ≤1 µg/mL of colistin and polymyxin, and yielded positive metallo-β-lactamase screening results. Eight isolates had blaNDM-1, and 1 isolate had a novel allele (blaNDM-6). All 8 patients had recently been in India or Pakistan, where 6 received inpatient health care. Plasmids carrying blaNDM frequently carried AmpC or extended spectrum β-lactamase genes. Two K. pneumoniae isolates and a K. pneumoniae isolate from Sweden shared incompatibility group A/C plasmids with indistinguishable restriction patterns and a common blaNDM fragment; all 3 were multilocus sequence type 14. Restriction profiles of the remaining New Delhi metallo-β-lactamase plasmids, including 2 from the same patient, were diverse.
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