伊朗广泛耐药及高毒力肺炎克雷伯菌ST15、ST147、ST377和ST442的检测
Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran.
作者信息
Davoudabadi Sara, Goudarzi Hossein, Goudarzi Mehdi, Ardebili Abdollah, Faghihloo Ebrahim, Sharahi Javad Yasbolaghi, Hashemi Ali
机构信息
1 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
出版信息
Acta Microbiol Immunol Hung. 2021 Sep 20. doi: 10.1556/030.2021.01562.
In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla TEM gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla NDM-6, bla OXA-48, bla CTX-M, bla SHV, and bla TEM genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance.
在本研究中，我们聚焦于伊朗广泛耐药（XDR）、泛耐药（PDR）以及高毒力肺炎克雷伯菌（hvKP）的出现情况。在2018年至2020年期间，共从不同临床标本中收集了52株肺炎克雷伯菌分离株。通过对毒力和荚膜血清型特异性基因进行PCR扩增来鉴定hvKP分离株。通过拉丝试验鉴定高黏液型肺炎克雷伯菌（hmKP）。采用纸片扩散法、Carba - NP试验和PCR方法来确定耐碳青霉烯类hvKP（CR - hvKP）、多重耐药hvKP（MDR - hvKP）、广泛耐药hvKP（XDR - hvKP）和泛耐药hvKP（PDR - hvKP）。通过多位点序列分型（MLST）对XDR - hvKP分离株进行分型。在所有肺炎克雷伯菌分离株中，14株（26.9%）被鉴定为hvKP，其中78.6%（11/14）为hmKP，然而，经典肺炎克雷伯菌（cKP）分离株中没有一株是hmKP。hvKP的主要荚膜血清型是K2（42.85%），其次是K1（35.71%）。MDR - hvKP、XDR - hvKP和PDR - hvKP分离株的患病率分别为6株（42.9%）、5株（35.7%）和1株（7.1%）。在85.7%的hvKP分离株中发现产超广谱β - 内酰胺酶（ESBL），其中大多数携带bla TEM基因（78.6%），6株（42.9%）为CR - hvKP。在hvKP分离株中，分别有1株（7.1%）、2株（14.3%）、3株（21.4%）、8株（28.6%）和11株（78.6%）携带bla NDM - 6、bla OXA - 48、bla CTX - M、bla SHV和bla TEM基因。根据MLST分析，2株、1株、1株和1株XDR - hvKP分离株分别属于ST15、ST377、ST442和ST147。由于高毒力与广泛耐药或泛耐药的结合，此类分离株的出现令人深感担忧。
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