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韩国铜绿假单胞菌 ST235 克隆中出现多粘菌素耐药性。

Emergence of colistin resistance in Pseudomonas aeruginosa ST235 clone in South Korea.

机构信息

Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.

Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.

出版信息

Int J Antimicrob Agents. 2017 Jun;49(6):767-769. doi: 10.1016/j.ijantimicag.2017.01.023. Epub 2017 Apr 6.

Abstract

In this study, the prevalence and characteristics of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa isolates in South Korea were investigated. Among 215 P. aeruginosa isolates collected from eight hospitals, 77 (35.8%) and 72 (33.5%) were resistant to imipenem and meropenem, respectively. Of the 77 imipenem-resistant isolates, MBL genes were identified in 34 isolates (bla in 33 isolates and bla in 1 isolate). All of the MBL-producing isolates belonged to a globally prevailing genotype, sequence type 235 (ST235), and all of the IMP-6-producing isolates showed a deletion of nucleotide 209 of the porin gene oprD. Of the 33 IMP-6-producing ST235 isolates, 9 were resistant to colistin and exhibited resistance to all antimicrobial agents included in this study. PhoPQ and PmrAB amino acid alterations were not identical in the colistin-resistant isolates, indicating independent emergence of colistin resistance in this high-risk clone. Carbapenem resistance in P. aeruginosa has increased in South Korea owing to the dissemination of IMP-6-producing ST235 isolates, which showed high-level resistance to meropenem. Emergence of colistin resistance in the disseminated resistant clone would be a significant threat because few alternatives are left for the treatment of systemic infections.

摘要

本研究调查了韩国产金属β-内酰胺酶(MBL)-阳性铜绿假单胞菌的流行率和特征。从 8 家医院采集的 215 株铜绿假单胞菌分离株中,分别有 77 株(35.8%)和 72 株(33.5%)对亚胺培南和美罗培南耐药。在 77 株亚胺培南耐药分离株中,有 34 株(33 株 blaNDM-1 和 1 株 blaNDM-5)检出 MBL 基因。所有 MBL 阳性分离株均属于一种流行的全球基因型,序列型 235(ST235),所有 IMP-6 产生分离株均显示孔蛋白基因 oprD 第 209 位核苷酸缺失。在 33 株 IMP-6 产生的 ST235 分离株中,有 9 株对粘菌素耐药,并对本研究中包含的所有抗菌药物均表现出耐药性。耐粘菌素分离株的 PhoPQ 和 PmrAB 氨基酸改变并不相同,表明在该高危克隆中,粘菌素耐药的独立出现。由于 IMP-6 产生的 ST235 分离株的传播,铜绿假单胞菌对碳青霉烯类的耐药性在韩国有所增加,这些分离株对美罗培南表现出高水平耐药性。传播的耐药克隆中出现粘菌素耐药性将是一个重大威胁,因为用于治疗全身感染的替代药物已经很少。

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