耶路撒冷流行的耐碳青霉烯类肺炎克雷伯菌：携带编码 aac(6')-Ib 的质粒的 512 型序列。
A carbapenem-resistant Klebsiella pneumoniae epidemic clone in Jerusalem: sequence type 512 carrying a plasmid encoding aac(6')-Ib.
机构信息
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University, Jerusalem, 91120, Israel.
出版信息
J Antimicrob Chemother. 2012 Apr;67(4):898-901. doi: 10.1093/jac/dkr552. Epub 2012 Jan 26.
OBJECTIVES
We characterized distinctive features of a hypertransmissible carbapenem-resistant Klebsiella pneumoniae (CRKP) clone that emerged at Hadassah Hospital, Ein-Kerem, Jerusalem, Israel, in 2006.
METHODS
Eleven CRKP isolated at Hadassah Hospital during 2005-09 were examined by antimicrobial susceptibility testing, PFGE and multilocus sequence typing (MLST). Plasmids were analysed by conjugation, restriction mapping, PCR and sequencing.
RESULTS
Divergence from the national epidemic sequence type (ST) ST258 to ST512 was observed early on. Carbapenem resistance was conferred by bla(KPC-3) carried on a plasmid apparently closely related to pKpQIL, also from Israel. This clone also carried a 15 kb plasmid, designated pAAC154, that carries a Tn1331 derivative containing the aac(6')-Ib gene. pAAC154 does not carry a bla(KPC) gene, but is similar to pS15, a plasmid from New York that carries bla(KPC-2).
CONCLUSIONS
A single CRKP clone ST512 has spread efficiently in our region. In this clone, aac(6')-Ib, common in CRKP strains, is carried on a different plasmid from bla(KPC-3).
目的
我们对 2006 年在以色列耶路撒冷哈达萨医院出现的一种具有高度传染性的耐碳青霉烯类肺炎克雷伯菌（CRKP）克隆的独特特征进行了描述。
方法
对 2005 年至 2009 年期间在哈达萨医院分离的 11 株 CRKP 进行了抗菌药物敏感性试验、PFGE 和多位点序列分型（MLST）分析。通过接合、限制图谱分析、PCR 和测序分析了质粒。
结果
从国家流行的 ST258 序列类型（ST）到 ST512 的早期观察到明显的分歧。碳青霉烯类耐药性由 bla(KPC-3) 基因携带，该基因位于一个质粒上，该质粒显然与来自以色列的 pKpQIL 密切相关。该克隆还携带一个 15kb 的质粒，命名为 pAAC154，它携带一个含有 aac(6')-Ib 基因的 Tn1331 衍生物。pAAC154 不携带 bla(KPC)基因，但与来自纽约的质粒 pS15 相似，后者携带 bla(KPC-2)基因。
结论
一种具有高度传染性的耐碳青霉烯类肺炎克雷伯菌（CRKP）克隆 ST512 在我们的地区已经有效地传播。在这个克隆中，常见于 CRKP 菌株的 aac(6')-Ib 基因位于与 bla(KPC-3)不同的质粒上。
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