Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil.
School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
Int J Infect Dis. 2019 Feb;79:101-103. doi: 10.1016/j.ijid.2018.11.012. Epub 2018 Nov 26.
The aim of this study was to investigate the bla gene, pathogenic potential, and antimicrobial resistance of clinical isolates of carbapenem-resistant Klebsiella pneumoniae isolated from patients admitted to the University Hospital of Londrina between January 2014 and March 2017.
bla and virulence genes were investigated using conventional PCR methods Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines of 2017. Clonal relationships of the New Delhi metallo-β-lactamase (NDM)-positive isolates were determined by enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus sequence typing (MLST).
A total of 825 K. pneumoniae were identified, with four isolates (Kp6408, Kp6410, Kp6411, and Kp6715) presenting the bla gene. All NDM-1-producing isolates showed co-production of bla and bla genes and also the virulence genes kfu, entB, mrkD, and fimH. Three isolates (Kp6408, Kp6410, and Kp6715) were classified as multidrug-resistant (MDR) and one (Kp6411) as extensively drug-resistant (XDR). ERIC-PCR analyses demonstrated that the isolates shared about 60% genetic similarity. MLST revealed four different sequence types (STs), described for the first time in Brazil, with two novel STs described in this study: ST3371 and ST3372.
This study reports the identification of NDM-1 associated with KPC and virulence genes in four MDR K. pneumoniae with STs first described in Brazil.
本研究旨在调查 2014 年 1 月至 2017 年 3 月期间从洛伦齐纳大学医院住院患者中分离的耐碳青霉烯类肺炎克雷伯菌临床分离株的 bla 基因、致病潜力和抗菌药物耐药性。
采用常规 PCR 方法检测 bla 和毒力基因。根据 2017 年临床和实验室标准协会指南，采用纸片扩散法进行抗菌药物敏感性试验。采用肠杆菌重复基因间一致性（ERIC）-PCR 和多位点序列分型（MLST）方法确定携带新德里金属β-内酰胺酶（NDM）的阳性分离株的克隆关系。
共鉴定出 825 株肺炎克雷伯菌，其中 4 株（Kp6408、Kp6410、Kp6411 和 Kp6715）携带 bla 基因。所有 NDM-1 产生菌均同时产生 bla 和 bla 基因以及毒力基因 kfu、entB、mrkD 和 fimH。3 株（Kp6408、Kp6410 和 Kp6715）被归类为多药耐药（MDR），1 株（Kp6411）被归类为广泛耐药（XDR）。ERIC-PCR 分析表明，这些分离株具有约 60%的遗传相似性。MLST 显示 4 种不同的序列类型（STs），这是在巴西首次描述的，其中两种新的 STs 在本研究中描述：ST3371 和 ST3372。
本研究报道了在巴西首次描述的 4 株耐碳青霉烯类肺炎克雷伯菌中发现 NDM-1 与 KPC 和毒力基因相关，且这些分离株具有 STs。
