Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany.
Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany.
Antimicrob Agents Chemother. 2024 Nov 6;68(11):e0060224. doi: 10.1128/aac.00602-24. Epub 2024 Oct 4.
Carbapenemase-producing (CP-Kp) isolates are a public health concern as they can cause severe hospital-acquired infections that are difficult to treat. It has recently been shown that CP-Kp can take up virulence factors from hypervirulent lineages. In this study, 109 clinical CP-Kp isolates from the University Hospital Cologne were examined for the presence of acquired virulence factors using whole-genome sequencing and phenotypic tests, and results were linked to clinical data. The virulence factor was present in 18/109 of the CP-Kp isolates. Other acquired virulence factors, such as , , , , , and hypervirulence-associated capsule types were detected in various combinations among these isolates. The -positive isolates produced OXA-232 ( = 7), OXA-48 ( = 6), OXA-48+NDM ( = 3), NDM, and KPC (each = 1), and 7/18 isolates were resistant to ceftazidime-avibactam, colistin, and/or cefiderocol. Four isolates carried hybrid plasmids that harbored acquired virulence factors alongside the carbapenemase genes or . In 15/18 patients, -positive CP-Kp were isolated from a clinically manifest infection site. Among these, four patients had osteomyelitis, and four patients died from pneumonia with OXA-232-producing ST231 isolates, three of them as part of an outbreak. In conclusion, acquired virulence factors are frequently detected in various combinations in carbapenemase-producing isolates in Germany, warranting continuous monitoring of infections caused by these strains.
产碳青霉烯酶的 (CP-Kp) 分离株是一个公共卫生关注点，因为它们可导致严重的医院获得性感染，且难以治疗。最近已经表明，CP-Kp 可以从高毒力谱系中获取毒力因子。在这项研究中，通过全基因组测序和表型试验，检测了科隆大学医院的 109 株临床 CP-Kp 分离株中获得的毒力因子的存在情况，并将结果与临床数据相关联。18/109 株 CP-Kp 分离株中存在毒力因子。在这些分离株中，还检测到其他获得的毒力因子，如 、 、 、 、 和与高毒力相关的荚膜型，以各种组合存在。-阳性分离株产生 OXA-232（=7）、OXA-48（=6）、OXA-48+NDM（=3）、NDM 和 KPC（各=1），7/18 株对头孢他啶-阿维巴坦、黏菌素和/或头孢地尔科耐药。4 株分离株携带杂合质粒，这些质粒除了携带碳青霉烯酶基因 或 外，还携带获得的毒力因子。在 18 例患者中，从临床表现感染部位分离出-阳性 CP-Kp。在这些患者中，有 4 例患有骨髓炎，有 4 例因肺炎死亡，携带 OXA-232 的 ST231 分离株，其中 3 例是疫情的一部分。总之，在德国产碳青霉烯酶的 分离株中经常以各种组合检测到获得的毒力因子，需要对这些菌株引起的感染进行持续监测。
