Protonotariou Efthymia, Meletis Georgios, Pilalas Dimitrios, Mantzana Paraskevi, Tychala Areti, Kotzamanidis Charalampos, Papadopoulou Dimitra, Papadopoulos Theofilos, Polemis Michalis, Metallidis Simeon, Skoura Lemonia
Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, S. Kiriakidi str. 1, 54636 Thessaloniki, Greece.
First Propedeutic Department of Internal Medicine, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Antibiotics (Basel). 2022 Jan 25;11(2):149. doi: 10.3390/antibiotics11020149.
Carbapenemase-producing (CPKP) emerged in Greece in 2002 and became endemic thereafter. Driven by a notable variability in the phenotypic testing results for carbapenemase production in isolates from the intensive care units (ICUs) of our hospital, we performed a study to assess the molecular epidemiology of CPKP isolated between 2016 and 2019 using pulse-field gel electrophoresis (PFGE) including isolates recovered from 165 single patients. We investigated the molecular relatedness among strains recovered from rectal surveillance cultures and from respective subsequent infections due to CPKP in the same individual (48/165 cases). For the optimal interpretation of our findings, we carried out a systematic review regarding the clonality of CPKP isolated from clinical samples in ICUs in Europe. In our study, we identified 128 distinguishable pulsotypes and 17 clusters that indicated extended dissemination of CPKP within the hospital ICU setting throughout the study period. Among the clinical isolates, 122 harbored KPC genes (74%), 2 harbored KPC+NDM (1.2%), 38 harbored NDM (23%), 1 harbored NDM+OXA-48 (0.6%), 1 harbored NDM+VIM (0.6%) and 1 harbored the VIM (0.6%) gene. Multiple CPKP strains in our hospital have achieved sustained transmission. The polyclonal endemicity of CPKP presents a further threat for the selection of pathogens resistant to last-resort antimicrobial agents.
产碳青霉烯酶（CPKP）于2002年在希腊出现，此后成为地方病。受我院重症监护病房（ICU）分离株碳青霉烯酶产生的表型检测结果显著差异的驱动，我们开展了一项研究，使用脉冲场凝胶电泳（PFGE）评估2016年至2019年间分离的CPKP的分子流行病学，其中包括从165例单一患者中分离的菌株。我们调查了从直肠监测培养物以及同一患者随后因CPKP引起的感染中分离的菌株之间的分子相关性（48/165例）。为了对我们的研究结果进行最佳解读，我们对欧洲ICU临床样本中分离的CPKP的克隆性进行了系统评价。在我们的研究中，我们鉴定出128种可区分的脉冲型和17个簇，这表明在整个研究期间CPKP在医院ICU环境中广泛传播。在临床分离株中，122株携带KPC基因（74%），2株携带KPC+NDM（1.2%），38株携带NDM（23%），1株携带NDM+OXA-48（0.6%），1株携带NDM+VIM（0.6%），1株携带VIM（0.6%）基因。我院多种CPKP菌株实现了持续传播。CPKP的多克隆地方性对选择耐最后手段抗菌药物的病原体构成了进一步威胁。
