Haverkate Manon R, Dautzenberg Mirjam J D, Ossewaarde Tjaco J M, van der Zee Anneke, den Hollander Jan G, Troelstra Annet, Bonten Marc J M, Bootsma Martin C J
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
PLoS One. 2015 Oct 20;10(10):e0140960. doi: 10.1371/journal.pone.0140960. eCollection 2015.
During a large hospital outbreak of OXA-48 producing bacteria, most K. pneumoniaeOXA-48 isolates were phenotypically resistant to meropenem or imipenem, whereas most E. coliOXA-48 isolates were phenotypically susceptible to these antibiotics. In the absence of molecular gene-detection E. coliOXA-48 could remain undetected, facilitating cross-transmission and horizontal gene transfer of blaOXA-48. Based on 868 longitudinal molecular microbiological screening results from patients carrying K. pneumoniaeOXA-48 (n = 24), E. coliOXA-48 (n = 17), or both (n = 40) and mathematical modelling we determined mean durations of colonisation (278 and 225 days for K. pneumoniaeOXA-48 and E. coliOXA-48, respectively), and horizontal gene transfer rates (0.0091/day from K. pneumoniae to E. coli and 0.0015/day vice versa). Based on these findings the maximum effect of horizontal gene transfer of blaOXA-48 originating from E. coliOXA-48 on the basic reproduction number (R0) is 1.9%, and it is, therefore, unlikely that phenotypically susceptible E. coliOXA-48 will contribute significantly to the spread of blaOXA-48.
在一家大型医院发生的产OXA - 48细菌暴发期间，大多数肺炎克雷伯菌OXA - 48分离株对美罗培南或亚胺培南表现出表型耐药，而大多数大肠杆菌OXA - 48分离株对这些抗生素表现出表型敏感。在缺乏分子基因检测的情况下，大肠杆菌OXA - 48可能仍未被检测到，从而促进blaOXA - 48的交叉传播和水平基因转移。基于对携带肺炎克雷伯菌OXA - 48（n = 24）、大肠杆菌OXA - 48（n = 17）或两者（n = 40）的患者进行的868次纵向分子微生物学筛查结果以及数学建模，我们确定了定植的平均持续时间（肺炎克雷伯菌OXA - 48和大肠杆菌OXA - 48分别为278天和225天）以及水平基因转移率（从肺炎克雷伯菌到大肠杆菌为0.0091/天，反之亦然为0.0015/天）。基于这些发现，源自大肠杆菌OXA - 48的blaOXA - 48水平基因转移对基本再生数（R0）的最大影响为1.9%，因此，表型敏感的大肠杆菌OXA - 48不太可能对blaOXA - 48的传播有显著贡献。
