Kocsis Erika, Gužvinec Marija, Butić Iva, Krešić Sanja, Crnek Sandra Šestan, Tambić Arjana, Cornaglia Giuseppe, Mazzariol Annarita
1 Department of Diagnostics and Public Health, University of Verona , Verona, Italy .
2 Institute of Medical Microbiology, Semmelweis University , Budapest, Hungary .
Microb Drug Resist. 2016 Mar;22(2):123-8. doi: 10.1089/mdr.2015.0083. Epub 2015 Oct 20.
Four NDM-1-producing Enterobacteriaceae strains (three Klebsiella pneumoniae and one Citrobacter koseri) were isolated between 2009 and 2011 through a nationwide surveillance for carbapenem-resistant Enterobacteriaceae in Croatia to study the molecular genetic background of blaNDM and the responsible plasmid types. Phenotypically, the clinical strains proved to be multidrug resistant. All strains remained susceptible to tigecycline and colistin. The clinical strains harbored variable antibiotic resistance determinants, notably, blaNDM-1, blaTEM-1, blaSHV-1, blaSHV-12, blaOXA-1, blaOXA-9, blaCTX-M-15, blaCMY-4, qnrB1, and aac(6')Ib-cr in different combinations. Two K. pneumoniae belonged to sequence type ST15 and one strain to ST16. As for the plasmid types, C. koseri and one of the ST15 K. pneumoniae carried IncR, and the second ST15 K. pneumoniae carried IncR and colE. The K. pneumoniae ST16 strain hosted A/C and colE plasmids. The blaNDM-1 gene was detected on conjugative high-molecular-weight plasmids, namely, A/C and IncR types. It is noteworthy that this is the first description of K. pneumoniae ST16 expressing NDM-1 in Europe. Remarkably, our study underscores the importance of the IncR plasmid as a reservoir of multidrug resistance. To the best of our knowledge, the IncR plasmid carrying blaNDM-1 in C. koseri is reported for the first time.
2009年至2011年间，通过克罗地亚全国范围内对耐碳青霉烯类肠杆菌科细菌的监测，分离出4株产NDM-1的肠杆菌科菌株（3株肺炎克雷伯菌和1株科氏柠檬酸杆菌），以研究blaNDM的分子遗传背景和相关质粒类型。从表型上看，这些临床菌株被证明具有多重耐药性。所有菌株对替加环素和黏菌素仍敏感。这些临床菌株携带多种抗生素耐药决定子，特别是blaNDM-1、blaTEM-1、blaSHV-1、blaSHV-12、blaOXA-1、blaOXA-9、blaCTX-M-15、blaCMY-4、qnrB1和aac(6')Ib-cr，它们以不同组合存在。2株肺炎克雷伯菌属于序列类型ST15，1株属于ST16。至于质粒类型，科氏柠檬酸杆菌和1株ST15肺炎克雷伯菌携带IncR质粒，第二株ST15肺炎克雷伯菌携带IncR和colE质粒。肺炎克雷伯菌ST16菌株携带A/C和colE质粒。blaNDM-1基因在接合性高分子量质粒上被检测到，即A/C型和IncR型。值得注意的是，这是欧洲首次对表达NDM-1的肺炎克雷伯菌ST16进行描述。值得注意的是，我们的研究强调了IncR质粒作为多重耐药性储存库的重要性。据我们所知，首次报道了科氏柠檬酸杆菌中携带blaNDM-1的IncR质粒。
