Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto - Universidade de São Paulo (USP), Ribeirão Preto, Brazil.
Companhia Ambiental Do Estado de São Paulo (CETESB), Ribeirão Preto, Brazil.
Ecotoxicol Environ Saf. 2020 Sep 15;201:110782. doi: 10.1016/j.ecoenv.2020.110782. Epub 2020 Jun 1.
Klebsiella pneumoniae is one of the most important pathogens related to hospital-acquired infections. The incidence of infections by hypervirulent K. pneumoniae (hvKp), especially community-acquired infections, has been increasing in recent decades. The occurrence of multidrug-resistant (MDR) hvKp has been increasingly reported worldwide decreasing the treatment options, which is a concern. Aquatic environments have been considered a reservoir of MDR pathogens, which contribute to the spread of MDR pathogens. Therefore, this study aimed to characterize MDR-hvKp strains obtained from public aquatic environments using whole genome sequencing in Brazil. Resistome analysis showed ARGs to β-lactams, quinolones, tetracyclines, sulfonamides, and fosfomycin as well as several metal resistance genes. Virulome analysis showed several virulence genes. Besides, genomic islands, CRISPR and prophage-related sequences were also detected. MLST analysis revealed the presence of two novel sequences types (STs) belonging to different clonal complexes (CCs) [ST4415 (CC515) and ST4416 (CC2654)], and one already described [ST661 (CC661)]. The presence of MDR-hvKp lineages in water sources belonging to STs and CCs associated with humans and animals shows the ability of these pathogens to spread to different aquatic environments. This study reports for the first time two novel STs of MDR-hvKp as well as the presence of a rare ST661 closely related to outbreaks in aquatic environments, and contributes to surveillance studies and MDR-hvKp monitoring worldwide.
肺炎克雷伯菌是与医院获得性感染相关的最重要病原体之一。近年来，高毒力肺炎克雷伯菌（hvKp）的感染发病率（尤其是社区获得性感染）不断上升。世界范围内越来越多地报道了多药耐药（MDR）hvKp 的发生，这降低了治疗选择，令人担忧。水生环境被认为是 MDR 病原体的储库，有助于 MDR 病原体的传播。因此，本研究旨在使用全基因组测序对巴西公共水生环境中分离的 MDR-hvKp 菌株进行特征描述。耐药组分析显示对β-内酰胺类、喹诺酮类、四环素类、磺胺类和磷霉素以及几种金属耐药基因的耐药性。毒力组分析显示了几种毒力基因。此外，还检测到基因组岛、CRISPR 和噬菌体相关序列。多位点序列分型（MLST）分析显示存在两种新的序列类型（ST），分别属于不同的克隆群（CC）[ST4415（CC515）和 ST4416（CC2654）]和一种已描述的 ST661（CC661）。在属于与人类和动物相关的 ST 和 CC 的水源中存在 MDR-hvKp 谱系，表明这些病原体有能力传播到不同的水生环境。本研究首次报道了两种新的 MDR-hvKp ST 以及与水生环境暴发密切相关的罕见 ST661 的存在，为全球的监测研究和 MDR-hvKp 监测做出了贡献。
