Skalova Anna, Chudejova Katerina, Rotova Veronika, Medvecky Matej, Studentova Vendula, Chudackova Eva, Lavicka Pavel, Bergerova Tamara, Jakubu Vladislav, Zemlickova Helena, Papagiannitsis Costas C, Hrabak Jaroslav
Department of Microbiology, Faculty of Medicine, and University Hospital Pilsen, Charles University, Pilsen, Czech Republic.
Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
Antimicrob Agents Chemother. 2017 Jan 24;61(2). doi: 10.1128/AAC.01889-16. Print 2017 Feb.
The aim of this study was to characterize the first cases and outbreaks of OXA-48-like-producing Enterobacteriaceae recovered from hospital settings in the Czech Republic. From 2013 to 2015, 22 Klebsiella pneumoniae isolates, 3 Escherichia coli isolates, and 1 Enterobacter cloacae isolate producing OXA-48-like carbapenemases were isolated from 20 patients. Four of the patients were colonized or infected by two or three different OXA-48-like producers. The K. pneumoniae isolates were classified into nine sequence types (STs), with ST101 being predominant (n = 8). The E. coli isolates were of different STs, while the E. cloacae isolate belonged to ST109. Twenty-four isolates carried bla, while two isolates carried bla or bla Almost all isolates (n = 22) carried bla-positive plasmids of a similar size (∼60 kb), except the two isolates producing OXA-181 or OXA-232. In an ST45 K. pneumoniae isolate and an ST38 E. coli isolate, S1 nuclease profiling plus hybridization indicated a chromosomal location of bla Sequencing showed that the majority of bla-carrying plasmids exhibited high degrees of identity with the pOXA-48-like plasmid pE71T. Additionally, two novel pE71T derivatives, pOXA-48_30715 and pOXA-48_30891, were observed. The bla-carrying plasmid was identical to the IncX3 plasmid pOXA181_EC14828, while the bla-carrying plasmid was a ColE2-type plasmid, being a novel derivative of pOXA-232. Finally, sequencing data showed that the ST45 K. pneumoniae and ST38 E. coli isolates harbored the IS1R-based composite transposon Tn6237 containing bla integrated into their chromosomes. These findings underlined that the horizontal transfer of pOXA-48-like plasmids has played a major role in the dissemination of bla in the Czech Republic. In combination with the difficulties with their detection, OXA-48 producers constitute an important public threat.
本研究的目的是对从捷克共和国医院环境中分离出的产OXA - 48样酶肠杆菌科细菌的首例病例和暴发情况进行特征描述。2013年至2015年期间，从20名患者中分离出22株产OXA - 48样碳青霉烯酶的肺炎克雷伯菌、3株大肠埃希菌和1株阴沟肠杆菌。其中4名患者被两种或三种不同的产OXA - 48样酶细菌定植或感染。肺炎克雷伯菌分离株分为9种序列类型（STs），其中ST101为主导型（n = 8）。大肠埃希菌分离株属于不同的STs，而阴沟肠杆菌分离株属于ST109。24株分离株携带bla，而两株分离株携带bla或bla。除了两株产OXA - 181或OXA - 232的分离株外，几乎所有分离株（n = 22）都携带大小相似（约60 kb）的bla阳性质粒。在一株ST45肺炎克雷伯菌分离株和一株ST38大肠埃希菌分离株中，S1核酸酶图谱分析及杂交表明bla位于染色体上。测序显示，大多数携带bla的质粒与pOXA - 48样质粒pE71T具有高度同源性。此外，还观察到两种新型pE71T衍生物，即pOXA - 48_30715和pOXA - 48_30891。携带bla的质粒与IncX3质粒pOXA181_EC14828相同，而携带bla的质粒是一种ColE2型质粒，是pOXA - 232的新型衍生物。最后，测序数据显示，ST45肺炎克雷伯菌和ST38大肠埃希菌分离株的染色体上含有基于IS1R的复合转座子Tn6237，其中整合有bla。这些发现强调，pOXA - 48样质粒的水平转移在捷克共和国bla的传播中起了主要作用。鉴于其检测困难，产OXA - 48酶的细菌构成了重要的公共威胁。
