Bathoorn E, Tsioutis C, da Silva Voorham J M, Scoulica E V, Ioannidou E, Zhou K, Rossen J W, Gikas A, Friedrich A W, Grundmann H
Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion, Crete, Greece.
J Antimicrob Chemother. 2016 May;71(5):1207-12. doi: 10.1093/jac/dkv467. Epub 2016 Jan 26.
KPC-2-producing Klebsiella pneumoniae (KPC-KP) ST258 has been rapidly expanding and is often associated with serious nosocomial infections. Last-line antibiotics such as colistin and tigecycline often remain the only treatment option. We describe here the evolving genetic background of KPC-KP isolates in Crete, Greece.
We tested the antibiotic susceptibility of 34 clinical isolates from patients hospitalized in 2010 and 2013-14. Whole-genome sequences of these isolates were analysed for acquired resistance genes and gene mutations.
All KPC-KP isolates belonged to ST258 with the exception of one ST147 isolate. From 2014, 26% of isolates were non-susceptible to all antibiotics, compared with 0 of 11 isolates from 2010. Colistin resistance was associated with mutations in mgrB, which was present in 61% of isolates from 2014. Core-genome MLST analysis showed that pan-resistant isolates were closely related and appeared in two separate clusters.
KPC-KP is rapidly evolving to pan-resistance in Crete. We identified molecular resistance markers for pan-resistant isolates and showed that core-genome MLST is a promising tool for molecular fingerprinting of KPC-KP ST258.
产KPC-2的肺炎克雷伯菌（KPC-KP）ST258正在迅速传播，且常与严重的医院感染相关。黏菌素和替加环素等最后一线抗生素往往仍是唯一的治疗选择。我们在此描述希腊克里特岛KPC-KP分离株不断演变的遗传背景。
我们检测了2010年以及2013 - 2014年住院患者的34株临床分离株的抗生素敏感性。对这些分离株的全基因组序列进行分析，以寻找获得性耐药基因和基因突变。
除1株ST147分离株外，所有KPC-KP分离株均属于ST258。从2014年起，26%的分离株对所有抗生素不敏感，而2010年的11株分离株中这一比例为0。黏菌素耐药与mgrB基因突变有关，该突变在2014年的分离株中占61%。核心基因组多位点序列分型分析表明，泛耐药分离株密切相关，并出现在两个独立的簇中。
在克里特岛，KPC-KP正在迅速演变为泛耐药。我们鉴定了泛耐药分离株的分子耐药标志物，并表明核心基因组多位点序列分型是KPC-KP ST258分子指纹识别的一种有前景的工具。
