Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
Department of Bacteriology, Leszek Giec Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, Katowice, Poland.
Pol J Microbiol. 2021 Mar;70(1):107-116. doi: 10.33073/pjm-2021-010. Epub 2021 Mar 19.
Carbapenem-resistant (CRKP) is an important bacterium of nosocomial infections. In this study, CRKP strains, which were mainly isolated from fecal samples of 14 patients in three wards of the hospital in the Silesia Voivodship, rapidly increased from February to August 2018. Therefore, we conducted microbiological and molecular studies of the CRKP isolates analyzed. Colonized patients had critical underlying diseases and comorbidities; one developed bloodstream infection, and five died (33.3%). Antibiotic susceptibilities were determined by the E-test method. A disc synergy test confirmed carbapenemase production. CTX-Mplex PCR evaluated the presence of resistance genes , , , and the genes , , , , , , and was detected with the PCR method. Clonality was evaluated by Multi Locus Sequence Typing (MLST) and Pulsed Field Gel Electrophoresis (PFGE). Six (40%) strains were of XDR (Extensively Drug-Resistant) phenotype, and nine (60%) of the isolates exhibited MDR (Multidrug-Resistant) phenotype. The range of carbapenem minimal inhibitory concentrations (MICs, μg/mL) was as follows doripenem (16 to >32), ertapenem (> 32), imipenem (4 to > 32), and meropenem (> 32). PCR and sequencing confirmed the , , , and genes in all strains. The isolates formed one large PFGE cluster (clone A). MLST assigned them to the emerging high-risk clone of ST147 (CC147) pandemic lineage harboring the gene. This study showed that the isolates detected in the multi-profile medical centre in Katowice represented a single strain of the microorganism spreading in the hospital environment.
耐碳青霉烯肠杆菌(CRKP)是一种重要的医院感染病原菌。本研究中,2018 年 2 月至 8 月,主要从西里西亚省医院三个病房的 14 名患者粪便样本中分离出的 CRKP 菌株迅速增加。因此,我们对分析的 CRKP 分离株进行了微生物学和分子学研究。定植患者均患有严重的基础疾病和合并症;1 例发生血流感染,5 例死亡(33.3%)。采用 E 试验法测定抗生素敏感性。碟协同试验证实产碳青霉烯酶。CTX-Mplex PCR 评估耐药基因的存在,PCR 方法检测到 、 、 、 、 、 、 、和 基因。通过多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)评估克隆性。6 株(40%)为 XDR(广泛耐药)表型,9 株(60%)为 MDR(多药耐药)表型。碳青霉烯类最小抑菌浓度(MIC,μg/mL)范围如下:多尼培南(16 至>32)、厄他培南(>32)、亚胺培南(4 至>32)和美罗培南(>32)。PCR 和测序证实所有菌株均携带 、 、 、和 基因。分离株形成一个大的 PFGE 簇(克隆 A)。MLST 将它们分配到携带 基因的新兴高风险 ST147(CC147)流行谱系的高风险克隆中。本研究表明,卡托维兹多模式医疗中心检测到的 分离株代表了一种在医院环境中传播的微生物单一菌株。