bla、bla、bla、bla 基因在携带 OmpK36 和 OmpK37 孔蛋白突变的多药耐药肺炎克雷伯菌 ST437 中的共存：意大利的首次报告。
Coexistence of bla, bla, bla, bla genes in multidrug-resistant K. pneumoniae ST437-carrying OmpK36 and OmpK37 porin mutations: First report in Italy.
机构信息
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy; Medicine Laboratory, San Salvatore Hospital, L'Aquila, Italy.
出版信息
J Glob Antimicrob Resist. 2024 Jun;37:24-27. doi: 10.1016/j.jgar.2024.02.015. Epub 2024 Feb 24.
OBJECTIVES
K. pneumoniae is a common cause of severe hospital-acquired infections. In the present study, we have characterised the whole-genome of two K. pneumoniae ST437 belonging to the clonal complex CC258.
METHODS
The whole-genome sequencing was performed by MiSeq Illumina, with a 2 × 300bp paired-end run. ResFinder 4.4.2 was used to detect acquired antimicrobial resistance genes (ARGs) and chromosomal mutations. Mobile genetic elements (plasmids and ISs) were identified by MobileElementFinder v1.0.3. The genome was also assigned to ST using MLST 2.0.9. Virulence factors were detected using the Virulence Factor Database (VFDB).
RESULTS
K. pneumoniae KPNAQ_1/23 and KPNAQ_2/23 strains, isolated from urine samples of hospitalised patients, showed resistance to most antibiotics, including ceftazidime-avibactam, ceftolozane-tazobactam, and meropenem-vaborbactam combinations. Both strains were susceptible only to cefiderocol. Multiple mechanisms of resistance were identified. Resistance to β-lactams was due to the presence of NDM-5, OXA-232, CTX-M-15, SHV-182 β-lactamases, and OmpK36 and OmpK37 porin mutations. Resistance to fluoroquinolones was mediated by chromosomal mutations in acrR, oqxAB efflux pumps, and the bifunctional gene aac(6')-Ib-cr.
CONCLUSION
The presence of different virulence genes makes these KPNAQ_1/23 and KPNAQ_2/23 high-risk clones.
目的
肺炎克雷伯菌是引起严重医院获得性感染的常见原因。在本研究中，我们对属于克隆复合体 CC258 的 2 株肺炎克雷伯菌 ST437 进行了全基因组特征分析。
方法
使用 MiSeq Illumina 进行全基因组测序，采用 2×300bp 配对末端测序。使用 ResFinder 4.4.2 检测获得的抗菌药物耐药基因（ARGs）和染色体突变。使用 MobileElementFinder v1.0.3 鉴定移动遗传元件（质粒和 ISs）。使用 MLST 2.0.9 将基因组分配到 ST 型。使用病毒因子数据库（VFDB）检测病毒因子。
结果
从住院患者尿液样本中分离的肺炎克雷伯菌 KPNAQ_1/23 和 KPNAQ_2/23 株对大多数抗生素（包括头孢他啶-阿维巴坦、头孢唑肟-他唑巴坦和美罗培南-沃巴坦组合）表现出耐药性。两株菌仅对头孢地尔敏感。鉴定出多种耐药机制。对β-内酰胺类的耐药性是由于存在 NDM-5、OXA-232、CTX-M-15、SHV-182 β-内酰胺酶和 OmpK36 和 OmpK37 孔蛋白突变。对氟喹诺酮类的耐药性是由 acrR、oqxAB 外排泵和双功能基因 aac(6')-Ib-cr 染色体突变介导的。
结论
不同毒力基因的存在使这些 KPNAQ_1/23 和 KPNAQ_2/23 成为高风险克隆。
Zotero 插件