Giakkoupi Panagiota, Tryfinopoulou Kyriaki, Polemis Michalis, Pappa Olga, Miriagou Vivi, Vatopoulos Alkiviadis
Department of Microbiology, National School of Public Health, Athens, Greece.
Hellenic Central Public Health Laboratory, Athens, Greece.
Diagn Microbiol Infect Dis. 2015 May;82(1):62-4. doi: 10.1016/j.diagmicrobio.2015.02.009. Epub 2015 Feb 23.
The objective of the study is to report a multidrug-resistant outbreak of Providencia stuartii that occurred in inpatients in the Athens area in 2012 resulting from a very successful transmissible A/C multidrug-resistant plasmid. Thirteen multidrug-resistant P. stuartii clinical isolates from 5 hospitals were studied. Molecular typing was performed by pulsed-field gel electrophoresis. Antibiotic resistance genes and their genetic surround were detected by PCR and sequencing. Plasmid analysis included conjugation experiments using liquid cultures, sizing by S1 digestion, and incompatibility replicon typing by PCR. Isolates were grouped into 2 distinct clonal types A and B, exhibiting similarity less than 70%. Isolates of type A were recovered from patients hospitalized in 4 different hospitals with no obvious epidemiological linkage, while isolates of type B were recovered from patients treated in a single hospital. Both clonal types harbored a conjugative plasmid of 130 bp and IncA/C replicon type carrying 5 β-lactamase genes bla(SHV-5), bla(VEB-1), bla(VIM-1), bla(OXA-10), and bla(TEM-1) and aminoglycosides resistant determinants. All β-lactamase genes were included in stable structures as IS26, IS1999, and In-e541. The current plasmid seemed to have many common determinants with previously reported plasmids derived from P. stuartii and Proteus mirabilis clinical isolates and exhibited the ability to circulate in nosocomial bacterial populations.
本研究的目的是报告2012年雅典地区住院患者中发生的一次斯氏普罗威登斯菌多重耐药暴发，此次暴发是由一个非常成功的可传播A/C型多重耐药质粒引起的。对来自5家医院的13株斯氏普罗威登斯菌多重耐药临床分离株进行了研究。通过脉冲场凝胶电泳进行分子分型。通过PCR和测序检测抗生素抗性基因及其遗传环境。质粒分析包括使用液体培养物进行接合实验、通过S1消化进行大小测定以及通过PCR进行不相容复制子分型。分离株被分为2个不同的克隆类型A和B，相似度小于70%。A类分离株从4家不同医院住院的患者中分离得到，无明显的流行病学联系，而B类分离株从一家医院接受治疗的患者中分离得到。两种克隆类型均携带一个130 bp的接合质粒和IncA/C复制子类型，携带5个β-内酰胺酶基因bla(SHV-5)、bla(VEB-1)、bla(VIM-1)、bla(OXA-10)和bla(TEM-1)以及氨基糖苷类抗性决定簇。所有β-内酰胺酶基因都包含在IS26、IS1999和In-e541等稳定结构中。当前的质粒似乎与先前报道的源自斯氏普罗威登斯菌和奇异变形杆菌临床分离株的质粒有许多共同的决定簇，并表现出在医院细菌群体中传播的能力。
