Dominance of IMP-4-Producing Enterobacter cloacae among Carbapenemase-Producing Enterobacteriaceae in Australia
Dominance of IMP-4-Producing Enterobacter cloacae among Carbapenemase-Producing Enterobacteriaceae in Australia
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DOI：
10.1128/aac.04378-14
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发表时间：
2015-07-01
影响因子：
4.9
通讯作者：
Paterson, David L.
中科院分区：
文献类型：
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作者：
Sidjabat, Hanna E.;Townell, Nicola;Paterson, David L.
产碳青霉烯酶肠杆菌科（CPE）的患病率在全球范围内不断增加。据报道，bla（IMP）是澳大利亚肠杆菌科中的主要碳青霉烯酶编码基因。然而，目前澳大利亚昆士兰州关于CPE的数据有限。2009年7月至2014年3月期间，从昆士兰州医院共分离出58株CPE分离株。通过基于Diversilab重复序列的PCR确定分离物的克隆性。采用PCR方法检测碳青霉烯酶、超广谱β-内酰胺酶和AmpC酶的耐药机制，以及氨基糖苷类耐药基因和质粒介导的喹诺酮类耐药基因。对与碳青霉烯酶编码基因相关的质粒类型进行了表征。大部分CPE为阴沟肠杆菌（n = 29）。大多数昆士兰州CPE分离株是IMP生产者，包括11个物种（n = 48）。鉴定出9株产NDM的肠杆菌科细菌。一种产NDM的肺炎克雷伯菌分离株同时产生OXA-48。一个K pneumoniae分离株是OXA-181生产者。IMP生产者的发病率在2013年大幅上升。blaIMP-4存在于所有IMP产生菌株中。bla（TEM）、qnrB和aacA 4在IMP-4生产者中是常见的。HI 2（67%）和L/M（21%）复制子与bla（IMP-4）相关。所有HI 2质粒均为序列类型1（ST 1）。除一家外，所有NDM生产商都拥有bla（CTX-M-15）。在NDM生产者中发现的16 S rRNA甲基化酶基因是阿尔马、rmtB、rmtC和rmtF。昆士兰州CPE患病率的大幅增加主要与E.在过去的2年中，具有携带bla（IMP-4）的HI 2质粒的梭菌菌株。患者中NDM生产者和/或OXA-48样生产者的输入也导致CPE的出现增加。
The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has been increasing worldwide. bla(IMP) has been reported to be the predominant carbapenemase-encoding gene within Enterobacteriaceae in Australia. However, there are limited data currently available on CPE from Queensland, Australia. A total of 58 CPE isolates were isolated between July 2009 and March 2014 from Queensland hospitals. The clonality of isolates was determined by Diversilab repetitive sequence-based PCR. The isolates were investigated for the resistance mechanisms carbapenemase, extended-spectrum beta-lactamase, and AmpC beta-lactamase and for aminoglycoside resistance and plasmid-mediated quinolone resistance genes by PCR. The plasmid types associated with carbapenemase-encoding genes were characterized. The majority of the CPE were Enterobacter cloacae (n = 29). The majority of Queensland CPE isolates were IMP producers and comprised 11 species (n = 48). Nine NDM-producing Enterobacteriaceae were identified. One NDM-producing Klebsiella pneumoniae isolate coproduced OXA-48. One K. pneumoniae isolate was an OXA-181 producer. The incidence of IMP producers increased significantly in 2013. blaIMP-4 was found in all IMP-producing isolates. bla(TEM), qnrB, and aacA4 were common among IMP-4 producers. The HI2 (67%) and L/M (21%) replicons were associated with bla(IMP-4). All HI2 plasmids were of sequence type 1 (ST1). All but one of the NDM producers possessed bla(CTX-M-15). The 16S rRNA methylase genes found among NDM producers were armA, rmtB, rmtC, and rmtF. The substantial increase in the prevalence of CPE in Queensland has been associated mainly with the emergence E. cloacae strains possessing HI2 plasmids carrying bla(IMP-4) over the past 2 years. The importation of NDM producers and/or OXA-48-like producers in patients also contributed to the increased emergence of CPE.