National Medicines Institute, Warsaw, Poland Faculty of Medicine in Plzeň, Charles University in Prague, Plzeň, Czech Republic.
National Medicines Institute, Warsaw, Poland.
J Antimicrob Chemother. 2015 Jul;70(7):1981-8. doi: 10.1093/jac/dkv055. Epub 2015 Mar 10.
The objective of this study was to perform a multinational survey of patients' colonization by metallo-β-lactamase (MBL)-producing Enterobacteriaceae, including their molecular characterization.
Patients in 18 hospital units across Europe and Israel (n = 17 945) were screened between mid-2008 and mid-2011. MBL-producing isolates were typed by PFGE and MLST. MBL genes were amplified and sequenced within their integrons. Plasmids with MBL genes were analysed by nuclease S1 plus hybridization profiling, mating and transformation assays, and by PCR-based replicon typing.
Ninety-one patients in nine centres (six countries), including 62 patients in two Greek ICUs, carried 94 non-duplicate MBL-producing organisms. Klebsiella pneumoniae isolates from Greece dominated (n = 57) and belonged mainly to ST147, ST36 and ST383. All but one of the isolates expressed VIM-1-type MBLs. Isolates of Greek origins produced five enzymes, including new VIM-39, encoded by class 1 integrons of four types. In-e541-like elements prevailed, comprising six variants located on IncR, IncFIIK, IncR + FIIK, IncR + A/C or non-typeable plasmids. The other group were new In4873 and In4863, being the first In416-like elements identified in Greece, which were present on IncA/C or non-typeable plasmids. Isolates from other countries produced only VIM-1 and the major integron was In916, identified in 16 organisms from France, Italy and Spain. In916 was carried by four plasmid types, including IncA/C, IncFIIK and IncHI2. Other integrons included a new element, In3103, in Spain and In110 identified only in Latvia.
This study provided fully comparable data on the occurrence and molecular characteristics of VIM-producing Enterobacteriaceae in a group of hospital units across Europe, documenting recent changes in their epidemiology.
本研究的目的是对产金属β-内酰胺酶（MBL）的肠杆菌科患者进行定植情况进行跨国调查，包括对其进行分子特征分析。
2008 年中期至 2011 年中期，在欧洲和以色列的 18 个医院病房对患者进行了筛选。通过 PFGE 和 MLST 对产 MBL 的分离株进行分型。在整合子内扩增和测序 MBL 基因。通过核酸酶 S1 加杂交谱分析、交配和转化试验以及基于 PCR 的复制子分型对携带 MBL 基因的质粒进行分析。
在 9 个中心（6 个国家）的 91 名患者中，包括希腊 2 个 ICU 中的 62 名患者，携带 94 种非重复产 MBL 生物体。来自希腊的肺炎克雷伯菌分离株占主导地位（n=57），主要属于 ST147、ST36 和 ST383。除 1 株外，所有分离株均表达 VIM-1 型 MBL。来自希腊的分离株产生了 5 种酶，包括由 4 种类型的 1 类整合子编码的新型 VIM-39。e541 样元件占主导地位，包括位于 IncR、IncFIIK、IncR+FIIK、IncR+A/C 或不可分型质粒上的 6 种变体。另一个组是新型的 In4873 和 In4863，是在希腊首次发现的 In416 样元件，存在于 IncA/C 或不可分型质粒上。其他国家的分离株仅产生 VIM-1，主要的整合子是在法国、意大利和西班牙的 16 株菌中发现的 In916。In916 由 4 种质粒类型携带，包括 IncA/C、IncFIIK 和 IncHI2。其他整合子包括西班牙的新型元件 In3103 和仅在拉脱维亚发现的 In110。
本研究提供了在欧洲一组医院病房中产 VIM 的肠杆菌科患者定植情况及其分子特征的完全可比数据，记录了其流行病学的最新变化。
