High Prevalence of 16s rRNA Methylase Genes Among Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae Isolates in a Chinese Tertiary Hospital
High Prevalence of 16s rRNA Methylase Genes Among Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae Isolates in a Chinese Tertiary Hospital
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中国一家三级医院的碳青霉烯类耐药高毒力肺炎克雷伯菌分离株中 16s rRNA 甲基化酶基因的高流行率。
DOI：
10.1089/mdr.2019.0482
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发表时间：
2020-05-19
影响因子：
2.6
通讯作者：
Zhang, Wei
中科院分区：
文献类型：
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作者：
Liao, Wenjian;Wang, Liang De;Zhang, Wei
从中国某三级医院收集39株碳青霉烯类耐药高毒力肺炎克雷伯菌（CR-hvKP），用于表征16 S rRNA甲基化酶基因的流行情况。总的来说，66.7%（26/39）的CR-hvKP分离株被发现携带16 S rRNA甲基化酶基因。16 S rRNA甲基化酶基因以阿尔马最常见（11/26，42.3%），其次为rmtB（8/26，30.8%），阿尔马和rmtB共存（7/26，26.9%）。所有临床分离株均携带至少一种碳青霉烯酶基因，其中blaKPC-2（79.5%，31/39）、blaNDM-1（10.3%，4/39）及blaKPC-2和blaNDM-1共携带（10.3%，4/39）。ESBL基因检出率为89.7%（35/39），其中blaSHV-1、blaTEM-1和blaCTX-M-14的检出率分别为61.5%（24/39）、71.8%（28/39）和89.7%（35/39）。除4株（89.7%，35/39）外，其余菌株均携带喹诺酮类耐药基因，其中qnrS（82.1%，32/39）、aac（6 '）-Ib-cr（79.5%，31/39）和qnrB（2.6%，1/39）。本研究首次发现26株hvKP同时携带碳青霉烯酶基因、ESBL基因、喹诺酮类耐药基因和16 S rRNA甲基化酶基因。多位点序列分型（MLST）分析将39株CR-hvKP分离株分为4个序列型（ST），ST 11占79.5%。脉冲场凝胶电泳（PFGE）分型结果表明，与MLST密切相关的菌株聚在主要的PFGE群中，其中A群占31个ST 11菌株。累积而言，16 S rRNA甲基化酶基因在CR-hvKP临床分离株中高度流行，尤其是ST 11;因此，持续监测这些产生16 S rRNA甲基化酶的CR-hvKP的流行病学至关重要，同时最大限度地降低氨基糖苷类耐药CR-hvKP的潜在风险。
Thirty-nine carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) isolates collected from a Chinese tertiary hospital were used in the characterization of the prevalence of 16S rRNA methylase genes. In total, 66.7% (26/39) of the CR-hvKP isolates were found to carry 16S rRNA methylase genes. The most frequently detected 16S rRNA methylase gene was armA (11/26, 42.3%), followed by rmtB (8/26, 30.8%), and coexistence of both armA and rmtB (7/26, 26.9%). All the clinical isolates were found to carry at least one carbapenemase gene, with blaKPC-2 (79.5%, 31/39), blaNDM-1 (10.3%, 4/39), and cocarrying blaKPC-2 and blaNDM-1 (10.3%, 4/39). A total of 89.7% (35/39) isolates carried extended-spectrum β-lactamase (ESBL) genes, including 61.5% (24/39) blaSHV-1, 71.8% (28/39) blaTEM-1, and 89.7% (35/39) blaCTX-M-14. All except four isolates (89.7%, 35/39) harbored quinolone resistance genes, with qnrS (82.1%, 32/39), aac(6')-Ib-cr (79.5%, 31/39), and qnrB (2.6%, 1/39). Twenty-six hvKP strains in this study were first reported to cocarry carbapenemase genes, ESBL genes, quinolone resistance genes, and 16S rRNA methylase genes simultaneously. Multilocus sequence typing (MLST) analysis assigned the 39 CR-hvKP isolates into 4 sequence types (STs), with ST11 encompassing 79.5% of the strains. Pulsed field gel electrophoresis (PFGE) typing showed that strains closely related by MLST clustered in major PFGE clusters, of which cluster A accounts for 31 ST11 isolates. Cumulatively, 16S rRNA methylase genes are highly prevalent in CR-hvKP clinical isolates especially for ST11; it is, therefore, critical to continuously monitor the epidemiology of these 16S rRNA methylase-producing CR-hvKP while simultaneously minimizing potential risks from aminoglycoside-resistant CR-hvKP.