Nishida Satoshi, Matsunaga Naohisa, Kamimura Yuta, Ishigaki Shinobu, Furukawa Taiji, Ono Yasuo
Department of Microbiology and Immunology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Department of Infection Control and Prevention, Teikyo University Hospital, Itabashi, Tokyo 173-8605, Japan.
Microorganisms. 2020 Nov 18;8(11):1816. doi: 10.3390/microorganisms8111816.
Carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat in healthcare settings worldwide.
We evaluated the presence of carbapenemase genes in CPE in a tertiary care university hospital in Tokyo, Japan.
Carbapenem-resistant clinical isolates were collected in 2018 at Teikyo University Hospital (Tokyo, Japan). Bacterial species were identified using MALDI-TOF MS. Carbapenemase production was evaluated using a carbapenemase inactivation method. The presence of carbapenemase genes was confirmed by multiplex PCR and DNA sequencing.
Four CPE isolates were identified: two complex strains and and strains. Three of the isolates ( complex and ) were IMP-1-type producers, including IMP-10 in their produced metallo-β-lactamase, and are epidemic in East Japan. The IMP-10-producing complex strain also produced CTX-M ESBL. The other CPE isolate () is a VIM-1 producer. VIM-1-producing is epidemic in Europe, especially in Greece. Accordingly, the VIM-1 producer was isolated from a patient with a medical history in Greece.
This study revealed the emergence of complex co-producing IMP-1-type carbapenemase and CTX-M ESBL, and producing VIM-1 carbapenemase in clinical isolates in Japan. Metallo-β-lactamase was the most prevalent type of carbapenemase at Teikyo University Hospital, especially IMP-1-type carbapenemase. The detection of VIM-1-producing suggests that epidemic CPE from overseas can spread to countries with low CPE prevalence, such as Japan, highlighting the need for active surveillance.
产碳青霉烯酶肠杆菌科细菌（CPE）是全球医疗机构中一种新出现的威胁。
我们评估了日本东京一家三级医疗大学医院中CPE碳青霉烯酶基因的存在情况。
2018年在帝京大学医院（日本东京）收集耐碳青霉烯临床分离株。使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）鉴定细菌种类。使用碳青霉烯酶灭活方法评估碳青霉烯酶的产生情况。通过多重聚合酶链反应（PCR）和DNA测序确认碳青霉烯酶基因的存在。
鉴定出4株CPE分离株：2株复合菌株以及 和 菌株。其中3株分离株（复合菌株和 ）是IMP-1型产生菌，其产生的金属β-内酰胺酶中包括IMP-10，在日本东部流行。产生IMP-10的复合菌株还产生CTX-M超广谱β-内酰胺酶（ESBL）。另一株CPE分离株（ ）是VIM-1产生菌。产生VIM-1的 在欧洲流行，尤其是在希腊。因此，该VIM-1产生菌分离自一名有希腊病史的患者。
本研究揭示了在日本临床分离株中出现了同时产生IMP-1型碳青霉烯酶和CTX-M ESBL的复合菌株，以及产生VIM-1碳青霉烯酶的 。金属β-内酰胺酶是帝京大学医院最常见的碳青霉烯酶类型，尤其是IMP-1型碳青霉烯酶。检测到产生VIM-1的 表明来自海外的流行CPE可传播至CPE流行率较低的国家，如日本，这凸显了进行主动监测的必要性。
