Spread of Klebsiella pneumoniae ST395 non-susceptible to carbapenems and resistant to fluoroquinolones in North-Eastern France

被引:23
作者
Muggeo, Anaelle [1 ,2 ]
Guillard, Thomas [1 ,2 ]
Klein, Frederic [1 ,2 ]
Reffuveille, Fany [3 ]
Francois, Caroline [4 ]
Babosan, Anamaria [2 ]
Bajolet, Odile [1 ,2 ]
Bertrand, Xavier [5 ,6 ]
de Champs, Christophe [1 ,2 ]
机构
[1] CHU Reims, Hop Robert Debre, Lab Bacteriol Virol Hyg, Rue Gen Koenig, F-51092 Reims, France
[2] Univ Reims, SFR CAP Sante, UFR Med, EA 4687, F-51092 Reims, France
[3] Univ Reims, SFR CAP Sante, UFR Pharm, EA BIOS 4691, F-51092 Reims, France
[4] CHU Reims, Serv Chirurg Pediat, Amer Mem Hosp, F-51092 Reims, France
[5] CHRU Besancon, Serv Hyg Hosp, F-25030 Besancon, France
[6] Univ Bourgogne Franche Comte, UMR Chronoenvironm 6249, F-25030 Besancon, France
关键词
PMQR; QRDR; Klebsiella pneumonia; Carbapenem; MLST; ST395; GRAM-NEGATIVE BACTERIA; ESCHERICHIA-COLI; IN-VITRO; ENTEROBACTERIACEAE; EMERGENCE; DISSEMINATION; DETERMINANTS; GENES; CLONE; SPP;
D O I
10.1016/j.jgar.2017.10.023
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Fluoroquinolones (FQs) are a potential treatment for infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae that are susceptible to these agents. Methods: Owing to increasing non-susceptibility to carbapenems among Enterobacteriaceae, in this study FQ resistance mechanisms were characterised in 36 ertapenem-non-susceptible Klebsiella pneumoniae isolated from North-Eastern France in 2012. The population structure was described by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results: Among the 36 isolates, 13 (36%) carried a carbapenemase encoding-gene. Decreased expression of the OmpK35-encoding gene might be considered a major resistance determinant that could explain the non-susceptibility to carbapenems. The carbapenemase-producing isolates carried the well-known IncL pOXA-48a plasmid. All 36 K. pneumoniae isolates also harboured a FQ resistance determinant. The aac(6')-Ib-cr gene was the major plasmid-mediated quinolone resistance (PMQR) determinant found in K. pneumoniae (89%; 32/36). MLST identified five sequence types (STs), with the most common being ST395 (69%; 25/36), followed by ST147 (17%; 6/36). ST395 strains showed ertapenem minimum inhibitory concentrations (MICs) ranging from 0.75-32 mu g/mL. Klebsiella pneumoniae ST395 isolates did not show enhanced biofilm formation or environmental survival but showed higher chlorhexidine MICs compared with ST147 isolates. Conclusions: These findings showed that (i) K. pneumoniae ST395 carrying pOXA-48a has spread in North-Eastern France, (ii) aac(6')-Ib-cr is predominant in carbapenem-non-susceptible K. pneumoniae, (iii) K. pneumoniae ST395 is resistant to chlorhexidine and (iv) FQs as an alternative to beta-lactams to treat ertapenem-non-susceptible K. pneumoniae are compromised. (C) 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:98 / 103
页数:6
相关论文
共 34 条
[1]   Emergence of carbapenemase-producing Gram-negative bacteria in Saint Petersburg, Russia [J].
Ageevets, Vladimir A. ;
Partina, Irina V. ;
Lisitsyna, Eugenia S. ;
Ilina, Elena N. ;
Lobzin, Yuri V. ;
Shlyapnikov, Sergei A. ;
Sidorenko, Sergei V. .
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 2014, 44 (02) :152-155
[2]   Characterization of carbapenemases, ESBLs, and plasmid-mediated quinolone determinants in carbapenem-insensitive Escherichia coli and Klebsiella pneumoniae in Riyadh hospitals [J].
Al-Agamy, Mohamed H. ;
Aljallal, Abduelah ;
Radwan, Hesham H. ;
Shibl, Atef M. .
JOURNAL OF INFECTION AND PUBLIC HEALTH, 2018, 11 (01) :64-68
[3]   Molecular Analysis of Ciprofloxacin Resistance Mechanisms in Malaysian ESBL-Producing Klebsiella pneumoniae Isolates and Development of Mismatch Amplification Mutation Assays (MAMA) for Rapid Detection of gyrA and parC Mutations [J].
Al-Marzooq, Farah ;
Yusof, Mohd Yasim Mohd ;
Tay, Sun Tee .
BIOMED RESEARCH INTERNATIONAL, 2014, 2014
[4]   Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015 [J].
Albiger, B. ;
Glasner, C. ;
Struelens, M. J. ;
Grundmann, H. ;
Monnet, D. L. .
EUROSURVEILLANCE, 2015, 20 (45) :17-34
[5]  
[Anonymous], EURO SURVEILL
[6]   Prevalence of PMQR genes in E. coli and Klebsiella spp. isolated from North-West of Morocco [J].
Benaicha, Houda ;
Barrijal, Said ;
Ezzakkioui, Fatima ;
Elmalki, Fatima .
JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE, 2017, 10 :321-325
[7]   The MIQE Guidelines: Minimum Information for Publication of Quantitative Real-Time PCR Experiments [J].
Bustin, Stephen A. ;
Benes, Vladimir ;
Garson, Jeremy A. ;
Hellemans, Jan ;
Huggett, Jim ;
Kubista, Mikael ;
Mueller, Reinhold ;
Nolan, Tania ;
Pfaffl, Michael W. ;
Shipley, Gregory L. ;
Vandesompele, Jo ;
Wittwer, Carl T. .
CLINICAL CHEMISTRY, 2009, 55 (04) :611-622
[8]   Identification of plasmids by PCR-based replicon typing [J].
Carattoli, A ;
Bertini, A ;
Villa, L ;
Falbo, V ;
Hopkins, KL ;
Threlfall, EJ .
JOURNAL OF MICROBIOLOGICAL METHODS, 2005, 63 (03) :219-228
[9]   Differentiation of IncL and IncM Plasmids Associated with the Spread of Clinically Relevant Antimicrobial Resistance [J].
Carattoli, Alessandra ;
Seiffert, Salome N. ;
Schwendener, Sybille ;
Perreten, Vincent ;
Endimiani, Andrea .
PLOS ONE, 2015, 10 (05)
[10]   Outbreak of OXA-48-Positive Carbapenem-Resistant Klebsiella pneumoniae Isolates in France [J].
Cuzon, Gaelle ;
Ouanich, Jocelyne ;
Gondret, Remy ;
Naas, Thierry ;
Nordmann, Patrice .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2011, 55 (05) :2420-2423