blaKPC-2 携带肺炎克雷伯菌在希腊（2009-10 年）流行的最新情况。

An update of the evolving epidemic of blaKPC-2-carrying Klebsiella pneumoniae in Greece (2009-10).

机构信息

Department of Microbiology, National School of Public Health, Athens, Greece.

出版信息

J Antimicrob Chemother. 2011 Jul;66(7):1510-3. doi: 10.1093/jac/dkr166. Epub 2011 May 4.

DOI:10.1093/jac/dkr166

PMID:21543359

Abstract

OBJECTIVES

To follow the epidemic of KPC-2-producing Klebsiella pneumoniae in Greece.

METHODS

KPC-2-producing isolates (n = 378) were collected during January 2009-April 2010 in 40 Greek hospitals. bla(KPC) and bla(VIM) were detected by PCR. Carbapenemase production was confirmed by spectrophotometry. Sequences flanking bla(KPC-2) and their plasmid carriers were studied. Isolates were typed by PFGE and multilocus sequence typing (MLST).

RESULTS

All 378 isolates were bla(KPC-2) positive; 18 also carried bla(VIM-1/VIM-4). Higher isolation frequencies were observed in Athens and Crete. Isolates were classified into 13 PFGE types and 11 sequence types (STs). ST258 was predominant (n = 322), followed by ST147 (n = 20), ST383 (n = 9), ST133 (n = 6), ST274 (n = 4) and ST323 (n = 3). Of the remaining isolates, seven were distributed into five STs (11, 17, 340 and the novel 494 and 495) and seven were not typed. bla(KPC-2) could not be transferred from ST258 isolates, in contrast to isolates of ST17, ST133, ST147, ST274, ST494 and ST495. All bla(KPC-2)-encoding plasmids were of similar size (∼100 kb) and showed indistinguishable restriction fragment length polymorphism (RFLP) patterns except those from the ST340 isolates. Sequences flanking bla(KPC-2) revealed that the Tn4401a isoform was present in plasmids from all STs except ST340 containing Tn4401b. Co-production of VIM enzymes was observed in isolates of ST147, ST323 and ST383.

CONCLUSIONS

Apart from the epidemic of KPC-2-producing K. pneumoniae belonging to ST258 in Greece, diffusion of bla(KPC-2) to at least 10 additional STs has taken place. Notably, strains from three of the latter STs (147, 323 and 383) were found to carry both bla(KPC-2) and bla(VIM).

摘要

目的

跟踪希腊产 KPC-2 肺炎克雷伯菌的流行情况。

方法

2009 年 1 月至 2010 年 4 月，在希腊的 40 家医院收集了 378 株产 KPC-2 的肺炎克雷伯菌。通过 PCR 检测 bla(KPC)和 bla(VIM)。通过分光光度法确认碳青霉烯酶的产生。研究 bla(KPC-2)侧翼序列及其质粒载体。通过 PFGE 和多位点序列分型（MLST）对分离株进行分型。

结果

378 株分离株均 bla(KPC-2)阳性；18 株还携带 bla(VIM-1/VIM-4)。在雅典和克里特岛的分离率较高。分离株分为 13 种 PFGE 型和 11 种序列型（ST）。ST258 占主导地位（n = 322），其次是 ST147（n = 20）、ST383（n = 9）、ST133（n = 6）、ST274（n = 4）和 ST323（n = 3）。其余分离株中，有 7 株分布在 5 个 ST 中（11、17、340 以及新的 494 和 495），7 株未分型。与 ST17、ST133、ST147、ST274、ST494 和 ST495 相比，ST258 分离株不能转移 bla(KPC-2)。所有 bla(KPC-2)编码质粒大小相似（~100 kb），除 ST340 分离株外，其限制片段长度多态性（RFLP）模式相同。bla(KPC-2)侧翼序列显示，Tn4401a 亚型存在于除 ST340 以外的所有 ST 型质粒中，而 Tn4401b 存在于 ST340 型质粒中。在 ST147、ST323 和 ST383 分离株中观察到同时产生 VIM 酶。