Institute of Medical Microbiology, Partner Site Giessen-Marburg-Langen, Justus Liebig University Giessen, Giessen, Germany.
German Center for Infection Research (DZIF), Partner Site Giessen-Marburg-Langen, Justus Liebig University Giessen, Giessen, Germany.
J Clin Microbiol. 2021 Feb 18;59(3). doi: 10.1128/JCM.02238-20.
A series of clinical NDM-5-producing isolates obtained from two surveillance networks for carbapenem-producing from 2018 to 2019, namely, Switzerland (NARA) and Germany (SurvCARE), were analyzed. The 33 NDM-5-producing isolates were highly resistant to β-lactams, including novel β-lactam/β-lactamase inhibitor combinations (ceftazidime-avibactam, imipenem-relebactam, and meropenem-vaborbactam), and remained susceptible to fosfomycin, colistin, and tigecycline. These isolates were assigned to different sequence types (STs) and indicated a predominance of isolates exhibiting ST167 in Switzerland and Germany ( = 10) (phylogenetic group C), followed by ST405 ( = 4) (phylogenetic group E), ST1284 ( = 4) (phylogenetic group C), and ST361 ( = 4) (phylogenetic group C). The gene was predominantly present on an IncF-type plasmid ( = 29) and, to a lesser extent, on the narrow-host-range IncX3 plasmid ( = 4). Sequence analyses of eight NDM-5 plasmids indicated that NDM-5-encoding F-type plasmids varied in size between 86 and 132 kb. The two IncX3 plasmids pCH8NDM5 and pD12NDM5 were 46 and 45 kb in size, respectively. The highly conserved genetic surrounding structures (ΔIS---IS) of both the F-type and IncX3 plasmids suggested a common genetic origin. The emergence of the NDM-5 carbapenemase was evidenced in particular for the ST167 clone, which is a successful epidemic clone known to be associated with both multiresistance and virulence traits and is therefore of high public health concern. The occurrence of clonally related NDM-5-producing isolates in Switzerland and Germany further indicates the international spread of this multidrug-resistant superbug at least throughout Europe.
对 2018 年至 2019 年从两个产碳青霉烯肠杆菌科监测网络（瑞士的 NARA 和德国的 SurvCARE）获得的一系列临床 NDM-5 产 分离株进行了分析。33 株产 NDM-5 的 对包括新型β-内酰胺/β-内酰胺酶抑制剂组合（头孢他啶-阿维巴坦、亚胺培南-雷巴他定和美罗培南-沃巴坦）在内的β-内酰胺类药物高度耐药，但仍对磷霉素、黏菌素和替加环素敏感。这些分离株被分配到不同的序列类型（ST），表明在瑞士和德国，以 ST167 型（ = 10）（进化群 C）为主导，其次是 ST405（ = 4）（进化群 E）、ST1284（ = 4）（进化群 C）和 ST361（ = 4）（进化群 C）。 基因主要存在于 IncF 型质粒（ = 29）上，其次是在窄宿主范围的 IncX3 质粒（ = 4）上。对 8 个 NDM-5 质粒的序列分析表明，携带 NDM-5 的 F 型质粒大小在 86 至 132 kb 之间不等。两个 IncX3 质粒 pCH8NDM5 和 pD12NDM5 的大小分别为 46 和 45 kb。F 型和 IncX3 质粒高度保守的 遗传周围结构（ΔIS---IS）表明它们具有共同的遗传起源。NDM-5 碳青霉烯酶的出现，特别是在 ST167 克隆中得到了证实，该克隆是一个成功的流行克隆，已知与多药耐药性和毒力特征有关，因此引起了公众的高度关注。瑞士和德国分离出具有克隆相关性的产 NDM-5 的 进一步表明，这种多药耐药超级细菌至少在整个欧洲范围内发生了国际传播。
