Institute of Medical Microbiology, Justus Liebig University Giessen, Giessen, Germany.
German Center for Infection Research (DZIF), Partner Site Giessen-Marburg-Langen, Justus-Liebig University Giessen, Giessen, Germany.
Front Cell Infect Microbiol. 2021 Nov 11;11:744431. doi: 10.3389/fcimb.2021.744431. eCollection 2021.
The rise of Carbapenem-resistant Enterobacterales (CRE) represents an increasing threat to patient safety and healthcare systems worldwide. spp., long considered not to be a classical nosocomial pathogen, in contrast to and , is fast gaining importance as a clinical multidrug-resistant pathogen. We analyzed the genomes of 512 isolates of 21 CRE species obtained from 61 hospitals within a three-year-period and found that spp. ( were increasingly detected (n=56) within the study period. The carbapenemase-groups detected in spp. were KPC, OXA-48/-like and MBL (VIM, NDM) accounting for 42%, 31% and 27% respectively, which is comparable to those of in the same study. They accounted for 10%, 17% and 14% of all carbapenemase-producing CRE detected in 2017, 2018 and 2019, respectively. The carbapenemase genes were almost exclusively located on plasmids. The high genomic diversity of is represented by 22 ST-types. KPC-2 was the predominantly detected carbapenemase (n=19) and was located in 95% of cases on a highly-conserved multiple-drug-resistance-gene-carrying pMLST15 IncN plasmid. KPC-3 was rarely detected and was confined to a clonal outbreak of ST18. OXA-48 carbapenemases were located on plasmids of the IncL/M (pOXA-48) type. About 50% of VIM-1 was located on different IncN plasmids (pMLST7, pMLST5). These results underline the increasing importance of the species as emerging carriers of carbapenemases and therefore as potential disseminators of Carbapenem- and multidrug-resistance in the hospital setting.
耐碳青霉烯肠杆菌科（CRE）的出现对全球患者安全和医疗体系构成了日益严重的威胁。与 和 不同， 种长期以来被认为不是经典的医院病原体，而作为一种临床多药耐药病原体，其重要性正在迅速增加。我们分析了三年内从 61 家医院获得的 21 种 CRE 物种的 512 株分离株的基因组，发现 种（ 在研究期间（n=56）越来越多地被检测到。在 种中检测到的碳青霉烯酶群为 KPC、OXA-48/-样和 MBL（VIM、NDM），分别占 42%、31%和 27%，与同一研究中的 相似。它们分别占 2017 年、2018 年和 2019 年检测到的所有产碳青霉烯酶 CRE 的 10%、17%和 14%。碳青霉烯酶基因几乎完全位于质粒上。 的高基因组多样性由 22 种 ST 型代表。KPC-2 是主要检测到的碳青霉烯酶（n=19），95%的情况下位于高度保守的多药耐药基因携带 pMLST15 IncN 质粒上。KPC-3 很少被检测到，仅限于 种的克隆爆发。OXA-48 碳青霉烯酶位于 IncL/M（pOXA-48）型质粒上。约 50%的 VIM-1 位于不同的 IncN 质粒上（pMLST7、pMLST5）。这些结果强调了 种作为新兴碳青霉烯酶载体的重要性，因此有可能在医院环境中传播碳青霉烯类和多药耐药性。
