Genetic Contexts of blaNDM-1 in Patients Carrying Multiple NDM-Producing Strains
Genetic Contexts of blaNDM-1 in Patients Carrying Multiple NDM-Producing Strains
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DOI：
10.1128/aac.01319-15
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发表时间：
2015-12-01
影响因子：
4.9
通讯作者：
Sidjabat, Hanna E.
中科院分区：
文献类型：
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作者：
Wailan, Alexander M.;Sartor, Anna L.;Sidjabat, Hanna E.
碳青霉烯类耐药决定簇 bla(NDM-1) 已在各种革兰氏阴性细菌和不同的质粒复制子类型 (Inc) 中发现。在这里，我们介绍了巴基斯坦两家医院的四名患者，他们的粪便样本中同时存在两到四种不同种类的产生 NDM-1 的革兰氏阴性杆菌。除了其他抗菌素耐药机制、质粒复制子谱和序列类型 (ST) 之外，我们还描述了这 11 种产生 NDM-1 的革兰氏阴性杆菌的 bla(NDM-1) 遗传背景，以便了解这些细菌内碳青霉烯类耐药性的潜在获得机制。从四名患者身上分离出的六种不同细菌中，鉴定出两种常见质粒类型（IncN2 和 IncA/C）携带 blaNDM-1。其中两个菌株是新型弗氏柠檬酸杆菌 ST 20 和 ST 21。在所有四名患者和四个不同物种中发现了相同的 IncN2 型 bla(NDM-1) 遗传背景。在两个不同物种以及四名患者中的两名中发现了 IncA/C 型 bla(NDM-1) 遗传背景。将遗传背景表征与其他分子流行病学方法相结合，我们能够通过将基因无关的细菌物种获得的携带 bla(NDM-1) 的碳青霉烯类耐药性的 IncN2 或 IncA/C 质粒联系起来，在遗传无关的细菌物种之间建立分子流行病学联系。通过结合质粒表征和深入的遗传背景评估，该分析强调了质粒在抗菌素耐药性中的重要性。它还提供了一种新方法来研究 bla(NDM-1) 相关通过质粒在细菌种和属之间传播的潜在机制。
The carbapenem resistance determinant bla(NDM-1) has been found in various Gram-negative bacteria and upon different plasmid replicon types (Inc). Here, we present four patients within two hospitals in Pakistan harboring between two and four NDM-1-producing Gram-negative bacilli of different species coresident in their stool samples. We characterize the bla(NDM-1) genetic contexts of these 11 NDM-1-producing Gram-negative bacilli in addition to other antimicrobial resistance mechanisms, plasmid replicon profiles, and sequence types (STs) in order to understand the underlying acquisition mechanisms of carbapenem resistance within these bacteria. Two common plasmid types (IncN2 and IncA/C) were identified to carry blaNDM-1 among the six different bacterial species isolated from the four patients. Two of these strains were novel Citrobacter freundii ST 20 and ST 21. The same IncN2-type bla(NDM-1) genetic context was found in all four patients and within four different species. The IncA/C-type bla(NDM-1) genetic context was found in two different species and in two of the four patients. Combining genetic context characterization with other molecular epidemiology methods, we were able to establish the molecular epidemiological links between genetically unrelated bacterial species by linking their acquisition of an IncN2 or IncA/C plasmid carrying bla(NDM-1) for carbapenem resistance. By combining plasmid characterization and in-depth genetic context assessment, this analysis highlights the importance of plasmids in antimicrobial resistance. It also provides a novel approach for investigating the underlying mechanisms of bla(NDM-1)-related spread between bacterial species and genera via plasmids.