[耐碳青霉烯肠杆菌科在日本大阪北部的区域传播,并伴有耐药性增强]。

Ryuichiro Abe
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引用次数: 0

摘要

随着多药耐药细菌的迅速传播,碳青霉烯耐药肠杆菌科(CRE)已被报道为世界范围内的一个主要问题,因为治疗方案有限。碳青霉烯耐药主要是由于碳青霉烯酶,一种碳青霉烯降解酶,主要编码在质粒上,在细菌物种间传播。然而,只有小规模的尝试来确定在区域范围内传播的质粒的相似性或适应性。我们分析了来自大阪北部地区43家医疗机构的230株携带blaIMP的CRE分离株,重点分析了耐药基因的主要载体质粒。结合全基因组测序和Southern blotting,发现pKPI-6质粒在遗传上不同的分离株中主要传播blaIMP-6,并出现了获得各种优势的衍生物。我们确定了可能导致隐形传播的异源抗性,这是由blaIMP-6的转录调控产生的,blaIMP-6通过染色体整合稳定,质粒多聚增强碳青霉烯抗性,或blaIMP-6单点突变引起的抗菌素耐药性扩大。本文讨论了CRE的区域传播机制和碳青霉烯类耐药性的增强,为预防CRE的传播提供了一些见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Regional dissemination of carbapenem-resistant Enterobacteriaceae accompanying with enhanced resistance in Northern Osaka, Japan].

With the rapid spread of multidrug-resistant bacteria, carbapenem-resistant Enterobacteriaceae (CRE) has been reported worldwide as a major concern because of limited treatment options. Carbapenem resistance is mainly due to carbapenem-ase, a carbapenem-degrading enzyme, which is mainly encoded on a plasmid to spread across bacterial species. However, there have been only small-scale attempts to determine the similarities or accommodations of the plasmids disseminating regionwide. We analysed the 230 CRE isolates carrying blaIMP from 43 medical facilities in the northern Osaka area focusing on the plasmids, the main carriers of the drug resistance genes. Combination of whole genome sequencing and Southern blotting revealed the predominant dissemination of blaIMP-6 by the pKPI-6 plasmid among genetically distinct isolates, as well as the emergences of derivatives that acquired various advantages. We iden-tified heteroresistance likely causing stealth transmissions, which was generated by the transcriptional regu-lation of blaIMP-6, stabilization of blaIMP-6 through chromosomal integration, enhanced carbapenem resistance through plasmid multimerization, or broadened antimicrobial resistance due to a single point mutation in blaIMP-6. In this article, I dis-cussed the mechanisms of regional spread of CRE and enhancement of carbapenem resistance providing the insights to prevent their disseminations.

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