Clinical Laboratory of Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Intensive Care Department of Taian City Central Hospital, Tai'an, China.
Front Public Health. 2021 Sep 1;9:724212. doi: 10.3389/fpubh.2021.724212. eCollection 2021.
The emergence of carbapenem-resistant hypervirulent (CR-hvKP) strains has increased the threat posed by . Here, we described an outbreak of 32 CR-hvKP isolates from the emergency intensive care unit (EICU) of a teaching hospital in China. Thirty-two CRKp isolates were collected from six patients and their surrounding environment in EICU. Antimicrobial susceptibility testing was performed using VITEK 2 compact system, E-test or the broth microdilution method. All isolates were serotyped, antimicrobial resistance genes and virulence-associated genes were screened using PCR. Multilocus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE) were employed to characterize the genetic relationships among the CPKP isolates. The virulence capability of 11 CRKp isolates from six patients was evaluated through larva infection assay. PFGE showed that all 32 isolates belonged to one cluster, and MLST revealed that belonged to ST11. All isolates exhibited high resistance to β-lactam antibiotics, quinolones, and aminoglycosides. They were susceptible to ceftazidime/averbatan, tigecycline, and colistin. All 32 isolates harbored , , , , and . The serotype of all 32 isolates was K57. All 32 isolates contained 6 virulence genes, namely, , and . Infection assays demonstrated high mortality in the model. Following measures implemented by the hospital, the outbreak was controlled. The mortality rate was 50.0%. The epidemiology of CR-hvKP should be monitored closely to detect early indications of this emerging public health threat.
产碳青霉烯酶高毒力肺炎克雷伯菌（CR-hvKP）的出现增加了其带来的威胁。在这里，我们描述了一起发生在中国一家教学医院急诊重症监护病房（EICU）的 32 株 CR-hvKP 菌株暴发事件。从 EICU 的六名患者及其周围环境中采集了 32 株 CRKp 分离株。使用 VITEK 2 compact 系统、E-test 或肉汤微量稀释法进行药敏试验。使用 PCR 筛选所有分离株的血清型、抗菌药物耐药基因和毒力相关基因。采用多位点序列分型（MLST）和脉冲场凝胶电泳（PFGE）对 CPKP 分离株的遗传关系进行分析。通过幼虫感染实验评估了来自六名患者的 11 株 CRKp 分离株的毒力能力。PFGE 显示所有 32 株分离株属于一个克隆群，MLST 显示属于 ST11。所有分离株对β-内酰胺类抗生素、喹诺酮类和氨基糖苷类药物表现出高度耐药性。它们对头孢他啶/阿维巴坦、替加环素和黏菌素敏感。所有 32 株分离株均携带、、、、和。所有 32 株分离株的血清型均为 K57。所有 32 株分离株均含有 6 种毒力基因，即、和。感染实验表明，在 模型中具有高死亡率。在医院采取措施后，疫情得到了控制。死亡率为 50.0%。应密切监测产碳青霉烯酶高毒力肺炎克雷伯菌的流行病学情况，以发现这一新兴公共卫生威胁的早期迹象。
