Andrade Leonardo Neves, Novais Ângela, Stegani Lenita Maria Marcato, Ferreira Joseane Cristina, Rodrigues Carla, Darini Ana Lucia Costa, Peixe Luisa
Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil.
UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
Diagn Microbiol Infect Dis. 2018 Jun;91(2):164-168. doi: 10.1016/j.diagmicrobio.2018.01.007. Epub 2018 Jan 12.
We performed a single-month snapshot study of the population diversity of multidrug resistant (MDR) Klebsiella pneumoniae isolates producing carbapenemases and/or extended-spectrum β-lactamases from four major hospitals in Brazil. Isolates produced diverse ESBL (CTX-M-2, -8, -15, SHV-2), KPC-2 or both (CTX-M-2 and KPC-2), linked to specific genetic backgrounds and plasmids from a few families (IncR, IncFIIk, IncL/M) that were shared among clonal lineages within and between hospitals. A high clonal diversity was identified, among isolates from the same ST (ST11, ST15, ST101 or ST340). Diverse capsular types (n=13 K-types) were identified, most of which linked to specific ST (ST11 and K27 or K64, ST101 and K17, ST340 and KL151, ST15 and K24 or ST17 and KL112). Isolates shared a common set of virulence genes (ureA, fimH, uge, wabG, mrkD, entB) and occasionally ybtS (42%) and kfuBC (18%). Our data suggest intra- and inter-hospital spread of common genetic structures and international MDR K. pneumoniae clones.
我们对巴西四家主要医院中产生碳青霉烯酶和/或超广谱β-内酰胺酶的多重耐药（MDR）肺炎克雷伯菌分离株的群体多样性进行了为期一个月的快照研究。分离株产生了多种超广谱β-内酰胺酶（CTX-M-2、-8、-15、SHV-2）、KPC-2或两者兼有（CTX-M-2和KPC-2），与来自少数几个家族（IncR、IncFIIk、IncL/M）的特定遗传背景和质粒相关，这些家族在医院内部和医院之间的克隆谱系中共享。在来自相同序列型（ST11、ST15、ST101或ST340）的分离株中发现了高度的克隆多样性。鉴定出了多种荚膜类型（n = 13种K型），其中大多数与特定的序列型相关（ST11和K27或K64、ST101和K17、ST340和KL151、ST15和K24或ST17和KL112）。分离株共享一组常见的毒力基因（ureA、fimH、uge、wabG、mrkD、entB），偶尔还共享ybtS（42%）和kfuBC（18%）。我们的数据表明常见遗传结构和国际多重耐药肺炎克雷伯菌克隆在医院内部和医院之间传播。
