Background: ESBL-producing strains of Klebsiella pneumoniae, one of the main causes of nosocomial and hospital-acquired infections, are commonly associated with therapeutic impasses. Surveillance of these multidrug-re...Background: ESBL-producing strains of Klebsiella pneumoniae, one of the main causes of nosocomial and hospital-acquired infections, are commonly associated with therapeutic impasses. Surveillance of these multidrug-resistant pathogens is a crucial tool for controlling and preventing infections. This surveillance involves the use of appropriate molecular and phenotypic typing techniques. The choice of techniques is based on criteria such as discriminatory power, intra- and inter-laboratory reproducibility, epidemiological concordance, ease of use and cost. The aim of our study was to identify clusters of Extended-Spectrum Beta-Lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae) strains circulating in neonatology using quantitative antibiogram (QA) and Pulsed Field Gel Electrophoresis (PFGE). Materials and Methods: This cross-sectional study included 55 K. pneumoniae strains isolated from a total of 513 samples. These various samples are taken from newborns, healthcare personnel, and the environment. K. pneumoniae identification followed standard bacteriological procedures and was confirmed using the Vitek® 2 (bioMérieux). The detection of the ESBL phenotype was performed using the synergy test. QA and PFGE were used to identify clonal relationships between the various strains isolated. Concordance between these two methods was assessed by calculating Cohen’s KAPPA coefficient and Simpson’s diversity index. Results: Among the 55 K. pneumoniae strains included in this study, 58.2% (32/55) were found to be Extended-Spectrum Beta-Lactamase (ESBL) producers. Most of these strains were isolated from neonatal samples (blood samples and rectal swabs). The quantitative antibiogram method applied to 28 out of the 32 ESBL-producing strains revealed that the isolates were grouped into 5 clusters. Pulsed Field Gel Electrophoresis performed on a total of 16 ESBL-producing strains showed the existence of four profiles. A perfect concordance was observed between the two methods. Conclusion: The results of this study highlighted the existence of clonal strains of various origins within neonatology units.展开更多
耐碳青霉烯类抗生素肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)是临床常见的耐药菌之一。本研究对88株全国49家医院收集的CRKP菌株进行碳青霉烯类耐药基因检测,其中65株(73.9%)检出bla_(KPC)类基因(64株检出bla_(K...耐碳青霉烯类抗生素肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)是临床常见的耐药菌之一。本研究对88株全国49家医院收集的CRKP菌株进行碳青霉烯类耐药基因检测,其中65株(73.9%)检出bla_(KPC)类基因(64株检出bla_(KPC-2)、1株检出bla_(KPC-3))、9株(10.2%)检出bla_(NDM)类基因(均为bla_(NDM-1))、7株(8.0%)检出bla_(IMP)类基因(均为bla_(IMP-4))。通过多位点序列分型(multi-locus sequence typing,MLST)将88株CRKP分为25个MLST型,其中ST11型为优势型别,包含48株菌。88株CRKP通过脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)分为79个PFGE型,呈现高度多态性。本研究揭示了我国blaKPC-2阳性CRKP菌株存在克隆化现象,存在ST11型流行克隆;而bla_(NDM-1)和bla_(IMP-4)阳性CRKP菌株分子型别多态性大,还没形成流行克隆。需要密切监测并采取措施控制携带blaKPC-2基因的ST11型CRKP的传播扩散。展开更多
文摘Background: ESBL-producing strains of Klebsiella pneumoniae, one of the main causes of nosocomial and hospital-acquired infections, are commonly associated with therapeutic impasses. Surveillance of these multidrug-resistant pathogens is a crucial tool for controlling and preventing infections. This surveillance involves the use of appropriate molecular and phenotypic typing techniques. The choice of techniques is based on criteria such as discriminatory power, intra- and inter-laboratory reproducibility, epidemiological concordance, ease of use and cost. The aim of our study was to identify clusters of Extended-Spectrum Beta-Lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae) strains circulating in neonatology using quantitative antibiogram (QA) and Pulsed Field Gel Electrophoresis (PFGE). Materials and Methods: This cross-sectional study included 55 K. pneumoniae strains isolated from a total of 513 samples. These various samples are taken from newborns, healthcare personnel, and the environment. K. pneumoniae identification followed standard bacteriological procedures and was confirmed using the Vitek® 2 (bioMérieux). The detection of the ESBL phenotype was performed using the synergy test. QA and PFGE were used to identify clonal relationships between the various strains isolated. Concordance between these two methods was assessed by calculating Cohen’s KAPPA coefficient and Simpson’s diversity index. Results: Among the 55 K. pneumoniae strains included in this study, 58.2% (32/55) were found to be Extended-Spectrum Beta-Lactamase (ESBL) producers. Most of these strains were isolated from neonatal samples (blood samples and rectal swabs). The quantitative antibiogram method applied to 28 out of the 32 ESBL-producing strains revealed that the isolates were grouped into 5 clusters. Pulsed Field Gel Electrophoresis performed on a total of 16 ESBL-producing strains showed the existence of four profiles. A perfect concordance was observed between the two methods. Conclusion: The results of this study highlighted the existence of clonal strains of various origins within neonatology units.
基金Funded by the projects of Chinese National Key Program of Mega Infectious Disease of the National 12th Five-Year Plan(Nos.2013ZX10003002-001 and 2013ZX10004217)~~
文摘耐碳青霉烯类抗生素肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)是临床常见的耐药菌之一。本研究对88株全国49家医院收集的CRKP菌株进行碳青霉烯类耐药基因检测,其中65株(73.9%)检出bla_(KPC)类基因(64株检出bla_(KPC-2)、1株检出bla_(KPC-3))、9株(10.2%)检出bla_(NDM)类基因(均为bla_(NDM-1))、7株(8.0%)检出bla_(IMP)类基因(均为bla_(IMP-4))。通过多位点序列分型(multi-locus sequence typing,MLST)将88株CRKP分为25个MLST型,其中ST11型为优势型别,包含48株菌。88株CRKP通过脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)分为79个PFGE型,呈现高度多态性。本研究揭示了我国blaKPC-2阳性CRKP菌株存在克隆化现象,存在ST11型流行克隆;而bla_(NDM-1)和bla_(IMP-4)阳性CRKP菌株分子型别多态性大,还没形成流行克隆。需要密切监测并采取措施控制携带blaKPC-2基因的ST11型CRKP的传播扩散。
