Department of Microbiology and Immunology, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.
Department of Microbiology and Immunology, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Int J Antimicrob Agents. 2023 Nov;62(5):106964. doi: 10.1016/j.ijantimicag.2023.106964. Epub 2023 Sep 4.
The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is related to the transmission of carbapenemase genes. Strains carrying more than one carbapenemase with a broadened spectrum of antibiotic resistance have been detected, which is concerning. Although bla-encoding ST11-KL47/KL64 strains are dominant, other clones are emerging. This study investigated 137 CRKP from patients' blood samples in Taiwan. Polymerase chain reaction (PCR) was used to identify carbapenemase genes and capsular (KL) types. Most strains (56%, 77/137) possessed bla alone; however, 12% (17/137) carried bla+bla and these strains showed high resistance to imipenem and meropenem. Strains carrying bla+bla predominantly belonged to KL51 (n=15), followed by KL64 (n=1) and KL47 (n=1). Whole-genome sequencing of one KL51 strain indicated that bla and bla are carried on two different plasmids. PCR was performed using specific primers located in these plasmids, and all bla+bla-encoding strains except the KL64 strain were considered to carry the two abovementioned plasmids. Genome analysis for the KL64 strain revealed that bla and bla are encoded in one plasmid. Notably, the KL51 bla plasmid shared high sequence similarity with the KL64 bla+bla plasmid, except the KL64 plasmid comprised a 15,040-bp insertion encoding bla. The data revealed KL51 as a predominant KL type carrying bla+bla, and identified a novel plasmid carrying bla+bla, highlighting the spread of specific plasmids and clones of CRKP in Taiwan.
产碳青霉烯酶肺炎克雷伯菌（CRKP）的出现与碳青霉烯酶基因的传播有关。已经检测到携带具有更广泛抗生素耐药性的一种以上碳青霉烯酶的菌株，这令人担忧。虽然 bla 编码的 ST11-KL47/KL64 菌株占优势，但其他克隆也在出现。本研究调查了台湾患者血液样本中的 137 株 CRKP。聚合酶链反应（PCR）用于鉴定碳青霉烯酶基因和荚膜（KL）型。大多数菌株（56%，77/137）单独携带 bla ；然而，12%（17/137）携带 bla+bla，这些菌株对亚胺培南和美罗培南表现出高度耐药性。携带 bla+bla 的菌株主要属于 KL51（n=15），其次是 KL64（n=1）和 KL47（n=1）。一株 KL51 菌株的全基因组测序表明，bla 和 bla 位于两个不同的质粒上。使用位于这些质粒上的特异性引物进行 PCR，除 KL64 菌株外，所有 bla+bla 编码菌株都被认为携带上述两个质粒。对 KL64 菌株的基因组分析表明，bla 和 bla 编码在一个质粒上。值得注意的是，KL51 bla 质粒与 KL64 bla+bla 质粒共享高度的序列相似性，除了 KL64 质粒包含一个编码 bla 的 15040bp 插入片段。这些数据显示 KL51 是携带 bla+bla 的主要 KL 型，并鉴定出一种携带 bla+bla 的新型质粒，突显了特定质粒和 CRKP 克隆在台湾的传播。
