Ragheb Suzan Mohammed, Osei Sekyere John
Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt.
Department of Medical Microbiology, School of Medicine, University of Pretoria, Pretoria, South Africa.
Ann N Y Acad Sci. 2024 May;1535(1):109-120. doi: 10.1111/nyas.15126. Epub 2024 Apr 5.
This study aimed to screen antibiotic resistance and virulence genes in carbapenem-resistant hypermucoviscous Klebsiella pneumoniae isolates from an Egyptian hospital. Among 38 previously confirmed carbapenem-nonsusceptible K. pneumoniae isolates, a string test identified three isolates as positive for hypermucoviscosity. Phenotypic characterization and molecular detection of carbapenemase- and virulence-encoding genes were performed. PCR-based multilocus sequence typing and phylogenetics were used to determine the clonality and global epidemiology of the strains. The coexistence of virulence and resistance genes in the isolates was analyzed statistically using a chi-square test. Three isolates showed the presence of carbapenemase-encoding genes (bla, bla, and bla), adhesion genes (fim-H-1 and mrkD), and siderophore genes (entB); the isolates belonged to sequence types (STs) 101, 1310, and 1626. The relatedness between these sequence types and the sequence types of globally detected hypermucoviscous K. pneumoniae that also harbor carbapenemases was determined. Our analysis showed that the resistance and virulence profiles were not homogenous. Phylogenetically, different clones clustered together. There was no significant association between the presence of resistance and virulence genes in the isolates. There is a need for periodic surveillance of the healthcare settings in Egypt and globally to understand the true epidemiology of carbapenem-resistant, hypermucoviscous K. pneumoniae.
本研究旨在筛选埃及一家医院耐碳青霉烯类高黏液型肺炎克雷伯菌分离株中的抗生素耐药基因和毒力基因。在38株先前已确认对碳青霉烯类不敏感的肺炎克雷伯菌分离株中，拉丝试验鉴定出3株为高黏液型阳性。进行了碳青霉烯酶和毒力编码基因的表型特征分析及分子检测。采用基于聚合酶链反应（PCR）的多位点序列分型和系统发育分析来确定菌株的克隆性和全球流行病学特征。使用卡方检验对分离株中毒力基因和耐药基因的共存情况进行统计学分析。3株分离株显示存在碳青霉烯酶编码基因（bla、bla和bla）、黏附基因（fim-H-1和mrkD）和铁载体基因（entB）；这些分离株属于序列类型（STs）101、1310和1626。确定了这些序列类型与全球检测到的同样携带碳青霉烯酶的高黏液型肺炎克雷伯菌的序列类型之间的相关性。我们的分析表明，耐药性和毒力谱并不均匀。在系统发育上，不同的克隆聚集在一起。分离株中耐药基因和毒力基因的存在之间没有显著关联。有必要对埃及和全球的医疗机构进行定期监测，以了解耐碳青霉烯类高黏液型肺炎克雷伯菌的真实流行病学情况。
