He Zhien, Xu Weifeng, Zhao Hang, Li Wei, Dai Yuanyuan, Lu Huaiwei, Zhao Liping, Zhang Changfeng, Li Yujie, Sun Baolin
Department of Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
College of Life Science and Technology, Mudanjiang Normal University, Mudanjiang, China.
Front Microbiol. 2022 Sep 23;13:996753. doi: 10.3389/fmicb.2022.996753. eCollection 2022.
has become a primary threat to global health because of its virulence and resistance. In 2015, China reported multidrug-resistant (MDR) and hypervirulent (hvKp) isolates. The emergence of MDR-hvKp poses a significant threat to public health. We collected 76 MDR isolates from the same hospital, of which there were a total of six MDR-hvKp isolates. We performed multilocus sequence typing (MLST) and capsular typing, whole genome sequencing, comparative genome analysis, and phylogenetic analysis as well as phenotypic experiments, including growth curves, mucoviscosity assay, infection model, human whole blood survival, and human neutrophil bactericidal assay to further characterize the samples. We identified six large plasmids carrying extended spectrum β-lactamase (ESBL) genes or carbapenemase genes ( , , , ), 9 plasmids containing other drug resistance genes, and 7 hypervirulence plasmids carrying and in ST11 MDR-hvKp isolates. Some of these plasmids were identical, whereas others differed only by insertion elements. In addition, we identified a plasmid, p21080534_1, that carries hypervirulence genes (, , ), a carbapenemase gene ( ), and an ESBL gene ( ), as well as MDR-hvKp 21072329, which did not carry or , but exhibited hypervirulence and hypermucoviscosity. ST11 MDR-hvKp derived from hypervirulence and multidrug resistance plasmids not only causes significant treatment difficulties, but also represents an unprecedented challenge to public health. Therefore, urgent measures are needed to limit further spread.
由于其毒力和耐药性，已成为全球健康的主要威胁。2015年，中国报告了多重耐药（MDR）和高毒力（hvKp）分离株。MDR-hvKp的出现对公共卫生构成了重大威胁。我们从同一家医院收集了76株MDR分离株，其中共有6株MDR-hvKp分离株。我们进行了多位点序列分型（MLST）和荚膜分型、全基因组测序、比较基因组分析和系统发育分析以及表型实验，包括生长曲线、黏液粘度测定、感染模型、人全血存活和人中性粒细胞杀菌测定，以进一步表征这些样本。我们鉴定出6个携带超广谱β-内酰胺酶（ESBL）基因或碳青霉烯酶基因（ 、 、 、 ）的大质粒，9个含有其他耐药基因的质粒，以及7个在ST11 MDR-hvKp分离株中携带 和 的高毒力质粒。其中一些质粒是相同的，而其他质粒仅因插入元件而不同。此外，我们鉴定出一个携带高毒力基因（ 、 、 ）、一个碳青霉烯酶基因（ ）和一个ESBL基因（ ）的质粒p21080534_1，以及MDR-hvKp 21072329，它不携带 或 ，但表现出高毒力和高黏液粘度。源自高毒力和多重耐药质粒的ST11 MDR-hvKp不仅造成了严重的治疗困难，也对公共卫生构成了前所未有的挑战。因此，需要采取紧急措施来限制其进一步传播。
