Department of Bio-Medical Sciences, Section of Microbiology, University of Catania, Catania, Italy.
Clin Microbiol Infect. 2011 Sep;17(9):1444-7. doi: 10.1111/j.1469-0691.2011.03572.x. Epub 2011 Jun 10.
We report the first outbreak caused by colistin-resistant Klebsiella pneumoniae producing KPC-3 carbapenamase in two Italian hospitals. This spread occurred in 1 month, and was caused by eight colistin-resistant and carbapenem-resistant Klebsiella pneumoniae isolates from eight patients. A further three isolates were obtained from the intestinal tract and pharyngeal colonization. All isolates were multidrug-resistant (MDR), including being resistant to colistin, but they were susceptible to gentamicin and tigecycline. PCR detection showed that all isolates harboured the bla(KPC-3) gene associated with bla(SHV-11) , bla(TEM-1) and bla(OXA-9) . All K. pneumoniae isolates, genotyped by pulsed-field gel electrophoresis and multilocus sequence typing, belonged to the same sequence type (ST)258 clone. From our data and a review of the international literature, K. pneumoniae ST258 seems to be the most widespread genetic background for KPC dissemination in Europe.
我们报告了两起因产 KPC-3 碳青霉烯酶的耐多粘菌素肺炎克雷伯菌引起的意大利医院内首次爆发。这种传播在 1 个月内发生，是由来自 8 位患者的 8 株耐多粘菌素和碳青霉烯类肺炎克雷伯菌引起的。另外 3 株从肠道和咽部定植分离到。所有分离株均为多重耐药（MDR），包括对多粘菌素耐药，但对庆大霉素和替加环素敏感。PCR 检测显示所有分离株均携带 bla(KPC-3)基因，该基因与 bla(SHV-11)、bla(TEM-1)和 bla(OXA-9)有关。通过脉冲场凝胶电泳和多位点序列分型对所有肺炎克雷伯菌分离株进行基因分型，均属于同一序列型（ST）258 克隆。根据我们的数据和国际文献综述，肺炎克雷伯菌 ST258 似乎是欧洲 KPC 传播最广泛的遗传背景。
