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来自哥伦比亚各地医院的肺炎克雷伯菌分离株的流行病学基因组学。

Epidemiological Genomics of Klebsiella pneumoniae isolates from hospitals across Colombia.

作者信息

Medina Victor A, García-Vega Angela S, Rodríguez Fernando, Triviño-García Enmanuel S, Robledo Jaime A, Leal Aura L, Galvis Julián C, Reyes Luis F, Okeke Iruka N, Couto Natacha, Kumaran Emmanuelle A, Lewis-Woodhouse Georgina, Argimon Silvia, Arevalo Stefany A, Underwood Anthony P, Fargetton Xavier, Aanensen David M, Donado-Godoy Maria P

机构信息

Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance (GHRU)-Colombia, CI Tibaitatá, Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), Bogotá, Colombia.

Grupo GERMEN - Laboratorio Médico de Referencia, Medellín, Colombia.

出版信息

NPJ Antimicrob Resist. 2025 Jul 21;3(1):64. doi: 10.1038/s44259-025-00127-x.

Abstract

Klebsiella pneumoniae is one of the most important nosocomial pathogens worldwide. In Colombia, K. pneumoniae has been identified as the second most frequent microbial etiologic agent of healthcare-associated infections. We conducted a prospective local study of 335 K. pneumoniae isolates in 26 nationwide hospitals from 2020 to 2021. We found that the spread of carbapenem resistance was mediated by successful clones belonging to sequence types (ST) such as ST11, ST1082, and ST307, related to intra-hospital infections. We observed that bla remains the primary resistance mechanism to carbapenems and that, unlike other countries, ST11 strains commonly carry bla. We identified the recent introduction and circulation of new sequence types with different resistance mechanisms and hypervirulence. Besides, we detected possible transmission events closely linked to carbapenemase-carrying strains, mainly in intensive care units. This study helps us understand how K. pneumoniae disseminates in Colombian hospitals and where to direct effective intervention measures.

摘要

肺炎克雷伯菌是全球最重要的医院病原体之一。在哥伦比亚,肺炎克雷伯菌已被确定为医疗保健相关感染的第二常见微生物病原体。我们在2020年至2021年期间对全国26家医院的335株肺炎克雷伯菌分离株进行了一项前瞻性本地研究。我们发现,碳青霉烯耐药性的传播是由属于序列类型(ST)的成功克隆介导的,如ST11、ST1082和ST307,这些与医院内感染有关。我们观察到,bla仍然是对碳青霉烯类药物的主要耐药机制,并且与其他国家不同,ST11菌株通常携带bla。我们确定了具有不同耐药机制和高毒力的新序列类型的近期引入和传播。此外,我们检测到可能与携带碳青霉烯酶的菌株密切相关的传播事件,主要发生在重症监护病房。这项研究有助于我们了解肺炎克雷伯菌在哥伦比亚医院中的传播方式以及有效干预措施的实施方向。

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