上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

ST571型产NDM-1肺炎克雷伯菌检出及分子流行病学研究

刘婧娴，俞静，刘瑛   

  1. 上海交通大学 医学院附属新华医院检验科 临床微生物室， 上海 200092
  • 出版日期:2015-03-28 发布日期:2015-03-26
  • 通讯作者: 刘瑛, 电子信箱: lywjw0129@163.com。
  • 作者简介:刘婧娴（1988—）， 女， 硕士生; 电子信箱: ljxwwwyy@163.com。

Isolation and molecular epidemiology of ST571 NDM-1 producing Klebsiella pneumoniae

LIU Jing-xian, YU Jing, LIU Ying   

  1. Department of Clinical Microbiology, Clinical Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2015-03-28 Published:2015-03-26

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摘要：

目的 探讨产新德里金属-β-内酰胺酶1(NDM-1)肺炎克雷伯菌检出的分子流行病学意义。方法 实验菌株为从临床标本中分离到的1株耐碳青霉烯类肺炎克雷伯菌。采用VITEK-2 Compact全自动微生物分析系统进行鉴定及药敏试验，PCR及测序方法检测NDM-1等碳青霉烯酶基因的表达，并对菌株进行质粒转移接合试验及多位点序列分型（MLST）。经检索PubMed收集其他地区产NDM-1肺炎克雷伯菌的MLST数据，采用eBURST V3软件及Tree drawing软件进行分析。结果 该菌株对包括碳青霉烯类在内的多种抗生素均高度耐药，携带NDM-1基因，MLST为ST571含有该基因的质粒通过接合方式成功转移到受体菌。共收集源自28个国家的238株产NDM-1肺炎克雷伯菌的MLST信息，包含41个ST型，CC258（clone complex）为主要流行株。结论 我国首次检出ST571型产NDM-1肺炎克雷伯菌，耐药基因可能通过质粒进行传播。产NDM-1肺炎克雷伯菌的分子分型呈多样化，以CC258流行最广，本实验菌株与该克隆复合体菌株的亲缘关系甚远。

关键词: 肺炎克雷伯菌, 新德里金属-β-内酰胺酶1, 多位点序列分型, 分子流行病学

Abstract:

Objective To investigate the molecular epidemiological significance of isolating a New Delhi metallo-β-lactamase-1 (NDM-1) producing Klebsiella pneumoniae (K. pneumoniae) strain. Methods The strain was a carbapenems resistant K. pneumoniae strain isolated from clinical samples. VITEK-2 Compact instrument was used for identification and antibiotic susceptibility test. Expressions of NDM-1 genes and carbapenemases genes were detected by the PCR. The transfer plasmid conjugation experiment and multilocus sequence typing (MLST) were performed. MLST data of NDM-1 producing K. pneumoniae from other areas was collected from PubMed and analyzed by eBURST V3 software and Tree drawing software. Results The isolated strain was highly resistant to many antibiotics including carbpenems and carried the NDM-1 gene. Plasmids that contained the NDM-1 gene were successfully transferred to recipient bacteria by conjugation and the MLST of K. pneumoniae strain was ST571. The MLST data of 283 NDM-1 producing K. pneumoniae strains from 28 countries were collected, including 42 ST strains. The major epidemic strain was CC258 strain (clone complex). Conclusion The ST571 NDM-1 producing K. pneumoniae strain is isolated in China for the first time. The drug resistant gene may be transmitted by plasmids. The molecular typing of NDM-1 producing K. pneumoniae is diverse. CC258 strain is the most epidemic strain. The isolated strain is genetically far from cloned CC258 strain.

Key words: Klebsiella pneumoniae, New Delhi metallo-beta-lactamase-1, multilocus sequence typing, molecular epidemiology