Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Biomedical and Biotechnological Sciences, section of Microbiology, University of Catania, Via Santa Sofia n.97, 95123, Catania, Italy.
Eur J Clin Microbiol Infect Dis. 2019 Sep;38(9):1687-1691. doi: 10.1007/s10096-019-03597-w. Epub 2019 Jun 5.
The aim of this study was to analyze the alarming spread of NDM-1- and OXA-48-co-producing Klebsiella pneumoniae clinical isolates, collected between October 2016 and January 2018 in a neonatal intensive care unit of the University Hospital, Catania, Italy, through whole genome sequencing. All confirmed carbapenem-resistant K. pneumoniae (CRKp) isolates were characterized pheno- and geno-typically, as well as by whole genome sequencing (WGS). A total of 13 CRKp isolates were identified from 13 patients. Pulsed-field gel electrophoresis (PFGE) was performed, and the multilocus sequence typing (MLST) scheme used was based on the gene sequence as published on the MLST Pasteur website. Core genome MLST (cgMLST) was also performed. All isolates co-carried bla and bla genes located on different plasmids belonging to the IncM/L and IncA/C2 groups, respectively. The 13 strains had identical PFGE profiles. MLST and cgMLST showed that K. pneumoniae was dominated by CRKp ST101 and two novel STs (ST3666 and ST3367), identified after submission to the MLST database for ST assignment. All isolates shared the same virulence factors such as type 3 fimbriae, genes for yersiniabactin biosynthesis, yersiniabactin receptor, and iron ABC transporter. They carried the wzi137 variant associated with the K17 serotype. To the best of our knowledge, this is the first report of two novel STs, 3366 and 3367, NDM-OXA-48-co-producing K. pneumoniae clinical isolates, in Italy.
这项研究的目的是通过全基因组测序分析 2016 年 10 月至 2018 年 1 月期间在意大利卡塔尼亚大学医院新生儿重症监护病房采集的产 NDM-1 和 OXA-48 型碳青霉烯酶肺炎克雷伯菌临床分离株令人震惊的传播情况。所有确认为耐碳青霉烯类肺炎克雷伯菌（CRKp）的分离株均通过表型和基因型以及全基因组测序（WGS）进行了特征描述。从 13 名患者中鉴定出 13 株 CRKp 分离株。进行了脉冲场凝胶电泳（PFGE），并使用基于 MLST Pasteur 网站上公布的基因序列的多位点序列分型（MLST）方案。还进行了核心基因组 MLST（cgMLST）。所有分离株均共同携带 bla 和 bla 基因，这些基因位于分别属于 IncM/L 和 IncA/C2 组的不同质粒上。13 株菌株的 PFGE 图谱完全相同。MLST 和 cgMLST 显示，肺炎克雷伯菌主要由 CRKp ST101 和两个新的 ST（ST3666 和 ST3367）组成，这些 ST 在提交给 MLST 数据库进行 ST 分配后被识别。所有分离株均具有相同的毒力因子，如 3 型菌毛、耶尔森菌生物合成基因、耶尔森菌素受体和铁 ABC 转运体。它们携带与 K17 血清型相关的 wzi137 变体。据我们所知，这是意大利首次报道两种新型 ST（3366 和 3367）和产 NDM-OXA-48 型肺炎克雷伯菌临床分离株。
