Abdalhamid Baha, Elhadi Nasreldin, Albunayan Samar, Alsamman Khaldoon, Aljindan Reem
Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, P. O. Box 15215, Saudi Arabia.
Department of Clinical Laboratory Science, College of Applied Medical Sciences, University of Dammam, Al Khobar, P. O. Box 2435, Saudi Arabia.
J Med Microbiol. 2017 Jul;66(7):859-863. doi: 10.1099/jmm.0.000480. Epub 2017 Jun 22.
The resistance determinants for carbapenems, fluoroquinolones and aminoglycosides were characterized in 16 extensively drug-resistant Klebsiella pneumoniae (XDRKPN) strains collected from Saudi hospitals during 2014.
PCR and sequencing were used to detect: blaKPC, blaNDM, blaVIM, blaIMP-1,blaOXA-48, blaCTX-M, blaTEM, blaSHV and ampC for β-lactam resistance; qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA and mutations of gyrA and parC for fluoroquinolone resistance; and aacA4, aacC2, aadA1, aphA6, armA and rmtB for aminoglycoside resistance. Enterobacterial repetitive intergenic consensus sequence-based PCR was performed to detect the clonal relatedness.
All isolates encoded blaCTX-M, aacC2 and aphA6, together with mutations in gyrA and parC. blaOXA-48, blaNDM-1, aadA1, aacA4, qnrB, aac(6')-Ib-cr, armA and/or rmtB were detected in different strains. At least 93.2 % clonal relatedness was detected among these strains.
To our knowledge, this is the first report describing XDRKPN encoding at least seven resistance determinants and harbouring methyltransferases in Saudi Arabia.
对2014年从沙特医院收集的16株广泛耐药肺炎克雷伯菌（XDRKPN）菌株的碳青霉烯类、氟喹诺酮类和氨基糖苷类耐药决定因素进行特征分析。
采用聚合酶链反应（PCR）和测序检测β-内酰胺类耐药的blaKPC、blaNDM、blaVIM、blaIMP-1、blaOXA-48、blaCTX-M、blaTEM、blaSHV和ampC；氟喹诺酮类耐药的qnrA、qnrB、qnrS、aac(6')-Ib-cr、qepA以及gyrA和parC突变；氨基糖苷类耐药的aacA4、aacC2、aadA1、aphA6、armA和rmtB。进行基于肠杆菌重复基因间共有序列的PCR以检测克隆相关性。
所有分离株均编码blaCTX-M、aacC2和aphA6，同时伴有gyrA和parC突变。在不同菌株中检测到blaOXA-48、blaNDM-1、aadA1、aacA4、qnrB、aac(6')-Ib-cr、armA和/或rmtB。这些菌株之间检测到至少93.２%的克隆相关性。
据我们所知，这是沙特阿拉伯首次报道描述编码至少七种耐药决定因素并携带甲基转移酶的XDRKPN。
