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加勒比群岛首例产NDM-1肺炎克雷伯菌病例。

First case of NDM-1 producing Klebsiella pneumoniae in Caribbean islands.

作者信息

Bastian Sylvaine, Nordmann Patrice, Creton Elodie, Malpote Edith, Thiery Guillaume, Martino Frederic, Breurec Sebastien, Dortet Laurent

机构信息

University Hospital of Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe, France.

INSERM U914 « Emerging Resistance to Antibiotic », Le Kremlin-Bicêtre, France; Associated National Reference Center to Antibiotic Resistance, Le Kremlin-Bicêtre, France; University of Fribourg, Fribourg, Switzerland; Hôpital Fribourgeois - Hôpital Cantonal, Fribourg, Switzerland.

出版信息

Int J Infect Dis. 2015 May;34:53-4. doi: 10.1016/j.ijid.2015.03.002. Epub 2015 Mar 5.

Abstract

OBJECTIVES

Characterize a NDM-1 producing K. pneumoniae isolate recovered from a patient hospitalized in Guadeloupe, French West Indies, after its transfer from Cuba

METHODS

Antibiotic susceptibilities were determined by the disk diffusion method, and E-test. Carbapenemase production was assessed using the Carba NP test. Antibiotic resistance determinants and their surrounding structures were characterized by PCR mapping and DNA sequencing. Transfer of the β-lactam resistance marker was attempted by liquid mating-out assays

RESULTS

Here we reported the first NDM-1 producing enterobacterial isolate recovered from Caribbean islands. This K. pneumoniae isolate belongs to a new sequence type (ST1649). The blaNDM-1 gene together with the aacA4 gene were carried on a self conjugative IncR plasmid of c.a. 80kb.

CONCLUSION

This study describes the first identification of a NDM-1 producer in Caribbean islands. The uncommon incompatibility group of the blaNDM-1 carrying plasmid and the uncommon ST type of the K. pneumoniae strain suggest a possible local emergence of NDM producers.

摘要

目的

对从古巴转至法属西印度群岛瓜德罗普岛住院患者体内分离出的一株产NDM-1肺炎克雷伯菌进行特征分析

方法

采用纸片扩散法和E试验测定抗生素敏感性。使用Carba NP试验评估碳青霉烯酶的产生情况。通过PCR定位和DNA测序对抗生素耐药决定簇及其周围结构进行特征分析。尝试通过液体外交配试验转移β-内酰胺耐药标记

结果

在此我们报告了从加勒比群岛分离出的首例产NDM-1肠杆菌菌株。该肺炎克雷伯菌菌株属于一个新的序列类型(ST1649)。blaNDM-1基因与aacA4基因位于一个约80kb的自我接合IncR质粒上。

结论

本研究描述了在加勒比群岛首次鉴定出产NDM-1的菌株。携带blaNDM-1质粒的罕见不相容群以及肺炎克雷伯菌菌株罕见的ST型表明NDM产生菌可能在当地出现。

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