Pons Maria J, Marí-Almirall Marta, Ymaña Barbara, Moya-Salazar Jeel, Muñoz Laura, Sauñe Sharon, Salazar-Hernández Richard, Vila Jordi, Roca Ignasi
Facultad de Medicina, Universidad Científica del Sur, Carr. Antigua Panamericana Sur 19, Villa El Salvador, Lima 15067, Peru.
Department of Clinical Microbiology, ISGlobal, Hospital Clínic, Universitat de Barcelona, Rosselló 149-153, 08036 Barcelona, Spain.
Microorganisms. 2020 Sep 11;8(9):1392. doi: 10.3390/microorganisms8091392.
The aim of this study was to characterize carbapenem-resistant (CR-Kp) isolates recovered from adults and children with severe bacteremia in a Peruvian Hospital in June 2018. Antimicrobial susceptibility was determined by disc/gradient diffusion and broth microdilution when necessary. Antibiotic resistance mechanisms were evaluated by PCR and DNA sequencing. Clonal relatedness was assessed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Plasmid typing was performed with a PCR-based method. Thirty CR-Kp isolates were recovered in June 2018. All isolates were non-susceptible to all β-lactams, ciprofloxacin, gentamicin and trimethoprim-sulfamethoxazole, while mostly remaining susceptible to colistin, tigecycline, levofloxacin and amikacin. All isolates carried the gene and were extended spectrum β-lactamase (ESBL) producers. PFGE showed four different pulsotypes although all isolates but two belonged to the ST348 sequence type, previously reported in Portugal. was located in an IncFIB-M conjugative plasmid. To our knowledge, this is the first report of an New Delhi metallo-β-lactamase (NDM)-producing recovered from both children and adults in Lima, Peru, as well as the first time that the outbreak strain ST348 is reported in Peru and is associated with NDM. Studies providing epidemiological and molecular data on CR-Kp in Peru are essential to monitor their dissemination and prevent further spread.
本研究的目的是对2018年6月在秘鲁一家医院从患有严重菌血症的成人和儿童中分离出的耐碳青霉烯类肺炎克雷伯菌（CR-Kp）菌株进行特征分析。必要时，通过纸片/梯度扩散法和肉汤微量稀释法测定抗菌药物敏感性。通过聚合酶链反应（PCR）和DNA测序评估抗生素耐药机制。使用脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）评估克隆相关性。采用基于PCR的方法进行质粒分型。2018年6月共分离出30株CR-Kp菌株。所有菌株对所有β-内酰胺类、环丙沙星、庆大霉素和复方新诺明均不敏感，而大多数菌株对黏菌素、替加环素、左氧氟沙星和阿米卡星仍敏感。所有菌株均携带该基因，且均为超广谱β-内酰胺酶（ESBL）产生菌。PFGE显示出四种不同的脉冲型，尽管除两株外所有菌株均属于ST348序列型，此前在葡萄牙有报道。该基因位于一个IncFIB-M接合质粒上。据我们所知，这是秘鲁利马首次报道从儿童和成人中分离出产生新德里金属β-内酰胺酶（NDM）的肺炎克雷伯菌菌株，也是秘鲁首次报道ST348暴发菌株并将其与NDM相关联。提供秘鲁CR-Kp流行病学和分子数据的研究对于监测其传播和防止进一步扩散至关重要。
