King Abdullah International Medical Research Center, Infectious Diseases Research Department, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
J Infect Public Health. 2020 Apr;13(4):647-650. doi: 10.1016/j.jiph.2020.01.003. Epub 2020 Feb 14.
Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae have been isolated from human patients in many countries across the globe but rarely in Saudi Arabia. Here we provide the genomic characterization of the first KPC-producing K. pneumoniae isolated from the urine of a patient in Riyadh, Saudi Arabia, who had a recent travel history to Egypt involving a medical procedure. Presence of KPC-encoding gene initially detected with the Xpert Carba-R assay was confirmed by traditional PCR. Susceptibility testing using the VITEK 2 system, E-test and microbroth dilution methods showed that the K. pneumoniae isolate, namely SA01_KPC-2, was resistant to all antibiotics except colistin and ceftazidime/avibactam. Whole-genome sequencing (WGS), performed on the Illumina Miseq instrument, identified the isolate as sequence type (ST) 383 and serotype KL30-D1 O1v2. Genome assembly of SA01_KPC-2 indicated the presence of two plasmids. Plasmid pSA01_KPC-2, of approximately 45.9 kb in size, harbored the bla flanked by ISKpn27 and ISKpn6 and had a backbone similar to published KPC-carrying IncX6 plasmids. The second plasmid pSA01_incHIB1, a derivative of published 372-kb plasmid pKpvST383, carried genes encoding virulence factors and resistance to five classes of antibiotics. The isolation of the first KPC producer in Saudi Arabia requires high attention and rapid interventions to prevent further spread.
产碳青霉烯酶肺炎克雷伯菌（KPC）已在全球许多国家的人类患者中分离出来，但在沙特阿拉伯却很少见。在此，我们提供了首例从沙特阿拉伯利雅得一名有近期埃及旅行史（涉及医疗程序）的患者尿液中分离出的产 KPC 肺炎克雷伯菌的基因组特征。最初使用 Xpert Carba-R 检测法检测到 KPC 编码基因，随后通过传统 PCR 进行了确认。使用 VITEK 2 系统、E 试验和微量肉汤稀释法进行药敏试验显示，该肺炎克雷伯菌分离株 SA01_KPC-2 除对黏菌素和头孢他啶/阿维巴坦外，对所有抗生素均耐药。对该分离株进行的全基因组测序（WGS）在 Illumina Miseq 仪器上进行，结果表明该分离株为 ST383 型和 KL30-D1 O1v2 血清型。SA01_KPC-2 的基因组组装表明存在两个质粒。大小约为 45.9kb 的质粒 pSA01_KPC-2 携带有 bla 基因，该基因被 ISKpn27 和 ISKpn6 包围，其骨架与已发表的携带 KPC 的 IncX6 质粒相似。第二个质粒 pSA01_incHIB1 是已发表的 372kb 质粒 pKpvST383 的衍生物，携带编码毒力因子和对五类抗生素耐药的基因。在沙特阿拉伯首次分离出产 KPC 菌，需要高度重视并迅速采取干预措施，以防止进一步传播。
