Servicio de Microbiología, Hospital Universitario La Paz, IdiPaz, Paseo de La Castellana 261, 28046 Madrid, Spain.
Servicio de Hepatología y Trasplante Hepático Infantil, Hospital Universitario La Paz, Paseo de La Castellana 261, 28046 Madrid, Spain.
Int J Antimicrob Agents. 2018 Nov;52(5):713-718. doi: 10.1016/j.ijantimicag.2018.08.012. Epub 2018 Aug 23.
Carbapenem-resistant Klebsiella pneumoniae have spread globally throughout tertiary hospitals. Many Carbapenem-resistant K. pneumoniae clinical isolates are multidrug-resistant (MDR) and may become eventually pandrug-resistant (PDR). Here we present the closed genome of a PDR VIM-1-producing K. pneumoniae strain (KP1050) obtained in a tertiary hospital. The isolate belonged to sequence type 54 (ST54) and had five extrachromosomal elements (four plasmids and a circular phage genome). Most of the antimicrobial resistance genes (ARGs) were located in two clusters borne by two of the plasmids, comprising a class 1 integron that contained up to 14 ARGs including a VIM-1 metallo-β-lactamase gene, and an IS26 transposon that contained a mobile element from Acinetobacter baumannii encoding the amikacin resistance gene aac(6')-Ian. A MDR isolate obtained 6 years previously was identified (KP1048) retrospectively and was sequenced. Comparison of the two genomes showed that chromosomal mutations in outer membrane porins as well as mutations in the ramR and phoQ genes contributed to increase the resistance spectrum.
产碳青霉烯酶肺炎克雷伯菌已在全球各三级医院中广泛传播。许多产碳青霉烯酶肺炎克雷伯菌临床分离株为多重耐药（MDR），并可能最终成为泛耐药（PDR）。在此，我们报告了一株产 VIM-1 型碳青霉烯酶 PDR 肺炎克雷伯菌（KP1050）的全基因组序列，该菌株从一家三级医院中获得。该分离株属于序列型 54（ST54），并带有五个染色体外元件（四个质粒和一个环状噬菌体基因组）。大多数抗菌药物耐药基因（ARGs）位于两个质粒上的两个簇中，包括一个含有多达 14 个 ARGs 的 1 类整合子，其中包括一个 VIM-1 金属β-内酰胺酶基因，以及一个含有来自鲍曼不动杆菌的可移动元件的 IS26 转座子，该元件编码阿米卡星耐药基因 aac(6')-Ian。我们回顾性地鉴定并测序了 6 年前获得的一个 MDR 分离株（KP1048）。对这两个基因组的比较表明，外膜孔蛋白的染色体突变以及 ramR 和 phoQ 基因的突变有助于增加耐药谱。
