Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Av. do Café, S/N, Monte Alegre, Ribeirão Preto, 14040-903, Brazil.
Environmental Company of the State of São Paulo, Ribeirão Preto, São Paulo, Brazil.
World J Microbiol Biotechnol. 2024 Apr 24;40(6):177. doi: 10.1007/s11274-024-03994-0.
During the COVID-19 pandemic, the occurrence of carbapenem-resistant Klebsiella pneumoniae increased in human clinical settings worldwide. Impacted by this increase, international high-risk clones harboring carbapenemase-encoding genes have been circulating in different sources, including the environment. The bla gene is the most commonly disseminated carbapenemase-encoding gene worldwide, whose transmission is carried out by different mobile genetic elements. In this study, bla-positive Klebsiella pneumoniae complex strains were isolated from different anthropogenically affected aquatic ecosystems and characterized using phenotypic, molecular, and genomic methods. K. pneumoniae complex strains exhibited multidrug-resistant and extensively drug-resistant profiles, spotlighting the resistance to carbapenems, ceftazidime-avibactam, colistin, and tigecycline, which are recognized as last-line antimicrobial treatment options. Molecular analysis showed the presence of several antimicrobial resistance, virulence, and metal tolerance genes. In-depth analysis showed that the bla gene was associated with three different Tn4401 isoforms (i.e., Tn4401a, Tn4401b, and Tn4401i) and NTE elements. Different plasmid replicons were detected and a conjugative IncN-pST15 plasmid harboring the bla gene associated with Tn4401i was highlighted. K. pneumoniae complex strains belonging to international high-risk (e.g., ST11 and ST340) and unusual clones (e.g., ST323, ST526, and ST4216) previously linked to clinical settings. In this context, some clones were reported for the first time in the environmental sector. Therefore, these findings evidence the occurrence of carbapenemase-producing K. pneumoniae complex strains in aquatic ecosystems and contribute to the monitoring of carbapenem resistance worldwide.
在 COVID-19 大流行期间,全球人类临床环境中碳青霉烯类耐药肺炎克雷伯菌的发生有所增加。受此影响,携带碳青霉烯酶编码基因的国际高危克隆在不同来源(包括环境)中传播。bla 基因是全球传播最广泛的碳青霉烯酶编码基因,其传播由不同的移动遗传元件完成。在这项研究中,从不同人为影响的水生生态系统中分离出 bla 阳性肺炎克雷伯菌复合体菌株,并通过表型、分子和基因组方法进行了特征描述。肺炎克雷伯菌复合体菌株表现出多药耐药和广泛耐药的特征,突出了对碳青霉烯类、头孢他啶-阿维巴坦、黏菌素和替加环素的耐药性,这些药物被认为是最后一线的抗菌治疗选择。分子分析显示存在几种抗菌药物耐药性、毒力和金属耐受性基因。深入分析表明,bla 基因与三种不同的 Tn4401 亚型(即 Tn4401a、Tn4401b 和 Tn4401i)和 NTE 元件有关。检测到不同的质粒复制子,并强调了携带 bla 基因的可接合 IncN-pST15 质粒与 Tn4401i 有关。属于国际高危(如 ST11 和 ST340)和不寻常克隆(如 ST323、ST526 和 ST4216)的肺炎克雷伯菌复合体菌株与临床环境有关。在这种情况下,一些克隆在环境领域中首次被报道。因此,这些发现证明了碳青霉烯类耐药肺炎克雷伯菌复合体菌株在水生生态系统中的存在,并有助于全球范围内监测碳青霉烯类耐药性。