Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain.
Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain.
Int J Antimicrob Agents. 2014 Dec;44(6):538-40. doi: 10.1016/j.ijantimicag.2014.08.006. Epub 2014 Sep 26.
The aim of this study was to characterise carbapenem-resistant Klebsiella pneumoniae isolates that caused an outbreak in a hospital in the south of Spain, originating from a patient transferred in 2012 from Italy. Forty-four K. pneumoniae isolates, recovered from 28 patients, were screened by PCR for extended-spectrum β-lactamase (ESBL) and carbapenemase genes and the products were further sequenced. Plasmids were transferred by electroporation and were classified using PCR-based Inc/rep typing and IncF subtyping. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to determine the genetic relatedness of the isolates. All isolates yielded positive modified Hodge test results, harboured bla(SHV-11), bla(TEM-1) and bla(KPC-3) genes, showed an identical PFGE pattern, and were assigned to clone sequence type 512 (ST512). The bla(KPC-3) gene was located on a 140-kb K2:A-:B-plasmid. In conclusion, the successful K. pneumoniae ST512 clone caused a major outbreak in Spain from an imported case and is the first description of an outbreak in this country due to the KPC-3-producing K. pneumoniae ST512 clone.
本研究旨在描述引起西班牙南部一家医院暴发疫情的耐碳青霉烯类肺炎克雷伯菌分离株，这些分离株源自 2012 年从意大利转来的一名患者。对 28 名患者的 44 株肺炎克雷伯菌分离株进行了 PCR 检测，以筛选出超广谱β-内酰胺酶（ESBL）和碳青霉烯酶基因，并对产物进行了进一步测序。通过电穿孔转移质粒，并使用基于 PCR 的 Inc/rep 分型和 IncF 亚型对其进行分类。脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）用于确定分离株的遗传相关性。所有分离株均产生阳性改良 Hodge 试验结果，携带 bla(SHV-11)、bla(TEM-1)和 bla(KPC-3)基因，表现出相同的 PFGE 模式，并被归为克隆序列型 512（ST512）。bla(KPC-3)基因位于一个 140kb 的 K2:A-:B-质粒上。总之，成功的肺炎克雷伯菌 ST512 克隆引起了西班牙的一次重大暴发，这是首例由产 KPC-3 的肺炎克雷伯菌 ST512 克隆引起的暴发。
