Department of Microbiology, Faculty of Medicine, and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic.
Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic.
Sci Rep. 2021 Aug 3;11(1):15732. doi: 10.1038/s41598-021-95285-z.
The aim of the present study is to describe the ongoing spread of the KPC-producing strains, which is evolving to an epidemic in Czech hospitals. During the period of 2018-2019, a total of 108 KPC-producing Enterobacterales were recovered from 20 hospitals. Analysis of long-read sequencing data revealed the presence of several types of bla-carrying plasmids; 19 out of 25 bla-carrying plasmids could be assigned to R (n = 12), N (n = 5), C (n = 1) and P6 (n = 1) incompatibility (Inc) groups. Five of the remaining bla-carrying plasmids were multireplicon, while one plasmid couldn't be typed. Additionally, phylogenetic analysis confirmed the spread of bla-carrying plasmids among different clones of diverse Enterobacterales species. Our findings demonstrated that the increased prevalence of KPC-producing isolates was due to plasmids spreading among different species. In some districts, the local dissemination of IncR and IncN plasmids was observed. Additionally, the ongoing evolution of bla-carrying plasmids, through genetic rearrangements, favours the preservation and further dissemination of these mobile genetic elements. Therefore, the situation should be monitored, and immediate infection control should be implemented in hospitals reporting KPC-producing strains.
本研究旨在描述持续扩散的产 KPC 菌株，该菌株在捷克医院中已发展为流行。在 2018-2019 年期间，从 20 家医院共分离出 108 株产 KPC 的肠杆菌科。长读测序数据分析显示存在多种类型的 bla 携带质粒；25 个 bla 携带质粒中的 19 个可归为 R（n=12）、N（n=5）、C（n=1）和 P6（n=1）不相容（Inc）组。其余 5 个 bla 携带质粒为多复制子，而一个质粒无法分型。此外，系统发育分析证实 bla 携带质粒在不同种属的肠杆菌科不同克隆之间传播。研究结果表明，产 KPC 分离株的流行率增加是由于质粒在不同种属之间传播所致。在一些地区，观察到 IncR 和 IncN 质粒的局部传播。此外，bla 携带质粒通过遗传重排不断进化，有利于这些移动遗传元件的保存和进一步传播。因此，应监测情况，并在报告产 KPC 菌株的医院立即实施感染控制。
