Expansion of ESBL-producing Klebsiella pneumoniae in hospitalized patients: A successful story of international clones (ST15, ST147, ST336) and epidemic plasmids (IncR, IncFIIK)

被引:111
作者
Rodrigues, Carla [1 ,2 ]
Machado, Elisabete [1 ,2 ]
Ramos, Helena [3 ]
Peixe, Luisa [1 ]
Novais, Angela [1 ]
机构
[1] Univ Porto, Fac Pharm, REQUIMTE, P-4050313 Oporto, Portugal
[2] Univ Fernando Pessoa, Fac Ciencias Saude, CEBIMED FP ENAS, P-4249004 Oporto, Portugal
[3] Hosp Geral Santo Antonio, Ctr Hosp Porto, P-4099001 Oporto, Portugal
关键词
Multi-level epidemiology; MLST; High-risk clones; CTX-M-15; SHV ESBL; TEM-10; COMPLETE NUCLEOTIDE-SEQUENCE; SPECTRUM BETA-LACTAMASES; ESCHERICHIA-COLI; MOLECULAR EPIDEMIOLOGY; GENETIC ENVIRONMENTS; ENTEROBACTERIACEAE; RESISTANCE; SPREAD; DISSEMINATION; CARBAPENEMASE;
D O I
10.1016/j.ijmm.2014.08.003
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The aim of this study was to characterize by a multi-level approach extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae isolates other than E. coli from Portuguese hospitals. Eighty-eight ESBL-producing clinical isolates (69 Klebsiella pneumoniae, 13 Enterobacter cloacae complex, 3 Klebsiella oxytoca, 1 Enterobacter asburiae, 1 Proteus mirabilis and 1 Serratia marcescens) recovered from hospitals located in the North (A) or Centre (B, C) regions during two time periods (2006-7 and 2010) were analyzed. Standard methods were used for bacterial identification, antibiotic susceptibility testing, ESBL characterization, clonal (PFGE, MLST) and plasmid (S1-PFGE, I-CeuI-PFGE, replicon typing, hybridization) analysis. Isolates produced mostly CIX-M-15 (47%) or SHV-12 (30%), and less frequently other SHV- (15%; SHV-2, -5, -28, -55, -106) or TEM- (9%; TEM-10, -24, -199)-types, with marked local and temporal variations. The increase of CIX-M-15 and diverse SHV ESBL-types observed in Hospital A was associated with the amplification of multidrug-resistant (MDR) K. pneumoniae epidemic clones (ST15, ST147, ST336). SHV-12 and TEM-type ESBLs were mostly identified in diverse isolates of different Enterobacteriaceae species in Hospitals B and C in 2006-7. Particular plasmid types were linked to bla(CTX-M-15) (IncR or non-typeable plasmids), bla(SHV-12) (IncR or IncHI2), bla(SHV-28/-55/-106) (IncFII(K1) or IncFII(K5)), bla(TEM-10) (IncL/M) OF bla(TEM-24) (IncA/C), mostly in epidemic clones. In our country, the amplification of CTX-M-15 and diverse SHV-type ESBL among non-E. coli Enterobacteriaceae is linked to international MDR K. pneumoniae clones (ST15, 5T147, ST336) and plasmid types (IncR, IncFII(K)). Furthermore, we highlight the potential of IncFIIK plasmids (here firstly associated with bla(SHV-2/-28/-55/-106)) to disseminate as antibiotic resistance plasmids. (C) 2014 Elsevier GmbH. All rights reserved.
引用
收藏
页码:1100 / 1108
页数:9
相关论文
共 48 条
[1]   Multilevel population genetics in antibiotic resistance [J].
Baquero, Fernando ;
Coque, Teresa M. .
FEMS MICROBIOLOGY REVIEWS, 2011, 35 (05) :705-706
[2]   Comparative Population Analysis of Klebsiella pneumoniae Strains with Extended-Spectrum β-Lactamases Colonizing Patients in Rehabilitation Centers in Four Countries [J].
Baraniak, A. ;
Izdebski, R. ;
Fiett, J. ;
Sadowy, E. ;
Adler, A. ;
Kazma, M. ;
Salomon, J. ;
Lawrence, C. ;
Rossini, A. ;
Salvia, A. ;
Vidal Samso, J. ;
Fierro, J. ;
Paul, M. ;
Lerman, Y. ;
Malhotra-Kumar, S. ;
Lammens, C. ;
Goossens, H. ;
Hryniewicz, W. ;
Brun-Buisson, C. ;
Carmeli, Y. ;
Gniadkowski, M. .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2013, 57 (04) :1992-1997
[3]   Klebsiella pneumoniae resistant to third-generation cephalosporins in five African and two Vietnamese major towns: multiclonal population structure with two major international clonal groups, CG15 and CG258 [J].
Breurec, S. ;
Guessennd, N. ;
Timinouni, M. ;
Le, T. A. H. ;
Cao, V. ;
Ngandjio, A. ;
Randrianirina, F. ;
Thiberge, J. M. ;
Kinana, A. ;
Dufougeray, A. ;
Perrier-Gros-Claude, J. D. ;
Boisier, P. ;
Garin, B. ;
Brisse, S. .
CLINICAL MICROBIOLOGY AND INFECTION, 2013, 19 (04) :349-355
[4]   Plasmids and the spread of resistance [J].
Carattoli, Alessandra .
INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY, 2013, 303 (6-7) :298-304
[5]   Comparative Genomic Analysis of KPC- Encoding pKpQIL- Like Plasmids and Their Distribution in New Jersey and New York Hospitals [J].
Chen, Liang ;
Chavda, Kalyan D. ;
Melano, Roberto G. ;
Jacobs, Michael R. ;
Koll, Brian ;
Hong, Tao ;
Rojtman, Albert D. ;
Levi, Michael H. ;
Bonomo, Robert A. ;
Kreiswirth, Barry N. .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2014, 58 (05) :2871-2877
[6]   Complete Sequence of a blaKPC-2-Harboring IncFIIK1 Plasmid from a Klebsiella pneumoniae Sequence Type 258 Strain [J].
Chen, Liang ;
Chavda, Kalyan D. ;
Melano, Roberto G. ;
Jacobs, Michael R. ;
Levi, Michael H. ;
Bonomo, Robert A. ;
Kreiswirth, Barry N. .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2013, 57 (03) :1542-1545
[7]   Complete nucleotide sequence of pK245, a 98-kilobase plasmid conferring quinolone resistance and extended-spectrum-β-lactamase activity in a clinical Klebsiella pneumoniae isolate [J].
Chen, Ying-Tsong ;
Shu, Hung-Yu ;
Li, ng-Hui Li ;
Liao, Tsai-Lien ;
Wu, Keh-Ming ;
Shiau, Yih-Ru ;
Yan, Jing-Jou ;
Su, Ih-Jen ;
Tsai, Shih-Feng ;
Lauderdale, Tsai-Ling .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (11) :3861-3866
[8]   KPC-2-encoding plasmids from Escherichia coli and Klebsiella pneumoniae in Taiwan [J].
Chen, Ying-Tsong ;
Lin, Jung-Chung ;
Fung, Chang-Phone ;
Lu, Po-Liang ;
Chuang, Yin-Ching ;
Wu, Tsu-Lan ;
Siu, L. Kristopher .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2014, 69 (03) :628-631
[9]  
Clinical and Laboratory Standards Institute, 2011, M100S21 CLSI S
[10]   Characterisation of the CTX-M-15-encoding gene in Klebsiella pneumoniae strains from the Barcelona metropolitan area: plasmid diversity and chromosomal integration [J].
Coelho, Alicia ;
Jose Gonzalez-Lopez, Juan ;
Miro, Elisenda ;
Alonso-Tarres, Carles ;
Mirelis, Beatriz ;
Nieves Larrosa, Maria ;
Maria Bartolome, Rosa ;
Andreu, Antonia ;
Navarro, Ferran ;
Johnson, James R. ;
Prats, Guillem .
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2010, 36 (01) :73-78