Thoms-Rodriguez Camille-Ann, Mazzulli Tony, Christian Nicole, Willey Barbara M, Boyd David A, Mataseje Laura F, Mulvey Michael R, Christie Celia D C, Nicholson Alison M
University of West Indies, Kingston, Jamaica.
J Infect Dev Ctries. 2016 Feb 28;10(2):183-7. doi: 10.3855/jidc.7094.
The global dissemination of the New Delhi metallo-beta-lactamase (NDM) gene among certain strains of bacteria has serious implications since the infections caused by such organisms pose a therapeutic challenge. Although the NDM gene has been detected in various parts of the world, this is the first report of its detection in the English-speaking Caribbean. The NDM producing Klebsiella pneumoniae was isolated from an Indian patient who had recently relocated to Jamaica.
Identification and susceptibility testing of the K. pneumoniae isolate was performed using the Vitek 2 automated system) in keeping with Clinical and Laboratory Standards Institute (CLSI) standards. It was identified as a metallobetalactamase producer using the Rosco KPC+MBL kit. Genotypic screening for common betalactamase (including carbapenemase) genes, was carried out using two multiplex PCRs: one for SHV-, TEM-, CTX-M-, OXA-1-, and CMY-2-types, and one for VIM-, KPC-, IMP-, OXA-48, GES-, and NDM-types. Strain typing was conducted by pulsed-field gel electrophoresis (PFGE) using XbaI and multi-locus sequencing (MLS). Plasmid isolation and analysis was also performed.
K. pneumoniae (N11-02395), not previously associated with the dissemination of the NDM in India, Sweden or the UK, was found to harbor the NDM-1 gene on plasmid pNDM112395.
The identification of the NDM-1 gene underscores the need for effective surveillance and infection control measures to identify and prevent spread of multidrug resistant Gram negative bacilli. Strict infection control measures implemented for this patient helped to prevent the spread of this organism to other patients.
新德里金属β-内酰胺酶（NDM）基因在某些细菌菌株中的全球传播具有严重影响，因为此类生物体引起的感染带来了治疗挑战。尽管NDM基因已在世界不同地区被检测到，但这是其在讲英语的加勒比地区被检测到的首次报告。产NDM的肺炎克雷伯菌是从一名最近移居牙买加的印度患者身上分离出来的。
使用Vitek 2自动化系统按照临床和实验室标准协会（CLSI）标准对肺炎克雷伯菌分离株进行鉴定和药敏试验。使用Rosco KPC+MBL试剂盒将其鉴定为金属β-内酰胺酶产生菌。使用两种多重PCR对常见β-内酰胺酶（包括碳青霉烯酶）基因进行基因型筛查：一种用于SHV-、TEM-、CTX-M-、OXA-1-和CMY-2型，另一种用于VIM-、KPC-、IMP-、OXA-48、GES-和NDM型。通过使用XbaI的脉冲场凝胶电泳（PFGE）和多位点测序（MLS）进行菌株分型。还进行了质粒分离和分析。
肺炎克雷伯菌（N11-02395），此前在印度、瑞典或英国未与NDM传播相关联，被发现其质粒pNDM112395上携带NDM-1基因。
NDM-1基因的鉴定强调了需要采取有效的监测和感染控制措施，以识别和预防多重耐药革兰氏阴性杆菌的传播。针对该患者实施的严格感染控制措施有助于防止这种生物体传播给其他患者。
