Soliman Ahmed M, Maruyama Fumito, Zarad Hoda O, Ota Atsushi, Nariya Hirofumi, Shimamoto Toshi, Shimamoto Tadashi
Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan.
Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt.
Microorganisms. 2020 Apr 20;8(4):595. doi: 10.3390/microorganisms8040595.
This study describes the first full genomic sequence of an and -carrying multidrug-resistant clinical isolate from Egypt. The strain was isolated in April 2015 from the sputum of a patient in Cairo, Egypt. The and genes were identified by PCR screening and DNA sequencing; the isolate was subjected to antimicrobial susceptibility testing, conjugation experiments, and whole genomic sequencing. and were carried by an IncHI2 plasmid, pAMS-38a (281,121 bp in size); the plasmid also carried genes conferring resistance against sulfonamides (), quinolones (), trimethoprim (), β-lactams (), aminoglycosides (, , , and ). The strain was susceptible to colistin (MIC, <0.25 μg/mL); this could be due to the absence of the / regulatory system located downstream of in Enterobacterales, which is involved in the induction of colistin-resistance. The genetic context of and was identified as IS--IS- and -----IS-, respectively. This is the first report of an and /IncHI2-carrying multidrug-resistant clinical isolate from Africa and the Middle East. Plasmids of the IncHI2 group and the two insertion sequences (IS, and IS) might be the main vehicles for dissemination of . Further screening for is essential for identifying its incidence and to prevent its dissemination.
本研究描述了从埃及分离出的携带blaCTX-M和blaNDM的多重耐药肺炎克雷伯菌临床分离株的首个全基因组序列。该菌株于2015年4月从埃及开罗一名患者的痰液中分离得到。通过PCR筛选和DNA测序鉴定blaCTX-M和blaNDM基因；对该分离株进行了药敏试验、接合实验和全基因组测序。blaCTX-M和blaNDM由IncHI2质粒pAMS-38a（大小为281,121 bp）携带；该质粒还携带赋予对磺胺类药物（sul1）、喹诺酮类药物（qnrS1）、甲氧苄啶（dfrA12）、β-内酰胺类（blaTEM-1B）、氨基糖苷类（aadA1、aph(3')-IIa、ant(3")-Ia和strA）耐药的基因。该菌株对黏菌素敏感（MIC，<0.25 μg/mL）；这可能是由于肠杆菌科细菌中位于mgrB下游的pmrA/pmrB调控系统缺失，该系统参与黏菌素耐药性的诱导。blaCTX-M和blaNDM的基因背景分别鉴定为IS26-blaCTX-M-IS26和ISAba125-blaNDM-ISAba125。这是非洲和中东地区首次报道携带blaCTX-M和blaNDM/IncHI2的多重耐药肺炎克雷伯菌临床分离株。IncHI2组质粒和两个插入序列（IS26和ISAba125）可能是blaNDM传播的主要载体。进一步筛查blaNDM对于确定其发生率和预防其传播至关重要。
