Klebsiella pneumoniae resistant to third-generation cephalosporins in five African and two Vietnamese major towns: multiclonal population structure with two major international clonal groups, CG15 and CG258
Klebsiella pneumoniae resistant to third-generation cephalosporins in five African and two Vietnamese major towns: multiclonal population structure with two major international clonal groups, CG15 and CG258
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DOI：
10.1111/j.1469-0691.2012.03805.x
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发表时间：
2013-04-01
影响因子：
14.2
通讯作者：
Brisse, S.
中科院分区：
文献类型：
--
作者：
Breurec, S.;Guessennd, N.;Brisse, S.
发展中国家第三代头孢菌素耐药(3GC-R)肺炎克雷伯菌的分子流行病学文献很少。从2007年2月至2008年3月，我们从马格里布(摩洛哥)、西非(塞内加尔、科特迪瓦)、中部非洲(喀麦隆)、东非(马达加斯加)和东南亚(越南)的七个主要城镇收集了135株3GC-R肺炎克雷伯菌。通过多位点序列分型，它们的遗传多样性很高(60种序列类型)，反映了多克隆。然而，几乎所有参与中心都检测到两个主要克隆群，CG15(n=23，占分离物的17%)和CG258(n=18，13%)。这两个主要的克隆群此前曾在世界其他地区被描述过，表明它们在全球范围内传播。肠杆菌重复性基因间一致序列-聚合酶链式反应在地方水平上的高度多样性表明，大多数分离物在流行病学上是无关的。这些菌株的特征是存在多个耐药决定因素，最显著的是aac(6)-Ib-cr、qnr和blaCTX-M-15基因同时存在，61株(45%)属于31个序列类型。这些分离株在包括喀麦隆(n=1)、越南(n=4)、马达加斯加(n=10)、科特迪瓦(n=12)、摩洛哥(n=13)和塞内加尔(n=21)在内的大片地区被检测到。这些结果对患者管理有重大意义，并突出了耐药决定因素的潜在储存库。
The molecular epidemiology of third-generation cephalosporin-resistant (3GC-R) Klebsiella pneumoniae in developing countries is poorly documented. From February 2007 to March 2008, we collected 135 3GC-R K.pneumoniae isolates from seven major towns in Maghreb (Morocco), West Africa (Senegal, Cote d'Ivoire), Central Africa (Cameroon), East Africa (Madagascar) and Southeast Asia (Vietnam). Their genetic diversity, assessed by multilocus sequence typing, was high (60 sequence types), reflecting multiclonality. However, two major clonal groups, CG15 (n=23, 17% of isolates) and CG258 (n=18, 13%), were detected in almost all participating centres. The two major clonal groups have previously been described in other parts of the world, indicating their global spread. The high diversity of enterobacterial repetitive intergenic consensus sequence-PCR banding patterns at the local level indicates that most isolates were epidemiologically unrelated. The isolates were characterized by the presence of multiple resistance determinants, most notably the concomitant presence of the aac(6)-Ib-cr, qnr and blaCTX-M-15 genes in 61 isolates (45%) belonging to 31 sequence types. These isolates were detected across a large geographical area including Cameroon (n=1), Vietnam (n=4), Madagascar (n=10), Cote d'Ivoire (n=12), Morocco (n=13) and Senegal (n=21). These results have major implications for patient management and highlight a potential reservoir for resistance determinants.