Institute for Infection Prevention and Control, Medical Center - University of Freiburg, Freiburg, Germany.
Department of Microbiology, Laiko General Hospital, Athens, Greece.
Microb Genom. 2023 Aug;9(8). doi: 10.1099/mgen.0.001082.
Carbapenem-resistant (CRKP) has emerged as a major clinical and public health threat. The rapid dissemination of this pathogen is driven by several successful clones worldwide. We aimed to investigate the CRKP clonal lineages, their antibiotic resistance determinants and their potential transmissions in a tertiary care hospital located in Athens, Greece. Between 2003 and 2018, 392 CRKP isolates from bloodstream infections were recovered from hospitalized patients. Whole genome sequencing (WGS) was performed on the Illumina platform to characterize 209 of these isolates. In total, 74 % (=155) of 209 isolates belonged to three major clonal lineages: ST258 (=108), ST147 (=29) and ST11 (=18). Acquired carbapenemase genes were the mechanisms of resistance in 205 isolates ( , =123; , =56; , =20; , =6). Strong associations (=0.0004) were observed between carbapenemase genes and clonal lineages. We first isolated -carrying ST147 strains during the early sampling period in 2003, followed by the emergence of -carrying ST258 in 2006 and -carrying ST11 in 2013. Analysis of genetic distances between the isolates revealed six potential transmission events. When contextualizing the current collection with published data, ST147 reflected the global diversity, ST258 clustered with isolates representing the first introduction into Europe and ST11 formed a distinct geographically restricted lineage indicative of local spread. This study demonstrates the changing profile of bloodstream CRKP in a tertiary care hospital over a 15 year period and underlines the need for continued genomic surveys to develop strategies to contain further dissemination. This article contains data hosted by Microreact.
耐碳青霉烯肠杆菌科细菌（CRKP）已成为主要的临床和公共卫生威胁。这种病原体的快速传播是由全球几个成功的克隆株驱动的。我们旨在研究位于希腊雅典的一家三级保健医院的 CRKP 克隆谱系、其抗生素耐药决定因素及其潜在传播。在 2003 年至 2018 年间，从住院患者的血流感染中分离出 392 株 CRKP 分离株。对其中 209 株进行了 Illumina 平台的全基因组测序（WGS）以进行特征分析。在总共 209 株分离株中，74%（155 株）属于三个主要的克隆谱系：ST258（108 株）、ST147（29 株）和 ST11（18 株）。获得性碳青霉烯酶基因是 205 株分离株（ ，=123； ，=56； ，=20； ，=6）耐药的机制。在碳青霉烯酶基因和克隆谱系之间观察到很强的关联（=0.0004）。我们首先在 2003 年的早期采样期间分离出携带 -内酰胺酶基因的 ST147 菌株，随后在 2006 年出现携带 -内酰胺酶基因的 ST258 菌株，在 2013 年出现携带 -内酰胺酶基因的 ST11 菌株。对分离株之间遗传距离的分析揭示了六个潜在的传播事件。当将当前的收集与已发表的数据进行对比时，ST147 反映了全球的多样性，ST258 聚类与代表首次引入欧洲的分离株聚类，ST11 形成了一个独特的、具有地域限制的谱系，表明存在局部传播。本研究表明，在 15 年的时间里，三级保健医院的血流 CRKP 发生了变化，并强调需要进行持续的基因组调查，以制定策略来遏制其进一步传播。本文包含由 Microreact 托管的数据。
