pQEB1:携带 bla KPC-2 的医院爆发质粒系。

IF 4 2区 生物学 Q1 GENETICS & HEREDITY
Robert A Moran, Mahboobeh Behruznia, Elisabeth Holden, Mark I Garvey, Alan McNally
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引用次数: 0

摘要

在伯明翰伊丽莎白女王医院(QE)对病人定植和临床感染的产碳青霉烯酶肠杆菌科细菌(CPE)进行基因组监测时,我们发现了一种携带多个抗生素耐药基因的 N 型质粒 pQEB1,其中包括碳青霉烯酶基因 bla KPC-2。pQEB1 品系令人担忧,因为它具有多药耐药性、其宿主范围和明显的传播性以及获得更多耐药基因的潜力。在三个序列类型(ST)的弗氏柠檬杆菌、两个序列类型的泄殖腔肠杆菌和三个克雷伯氏菌中发现了 pQEB1 的代表。在 2023 年 1 月至 2024 年 2 月的 13 个月期间,pQEB1 的宿主从 11 个不同的病人中分离出来,这些病人住在医院的各个病房。目前,GenBank 中 pQEB1 菌系的唯一代表是 2016 年从 QE 的血液样本中分离出的霍乱弧菌和 2023 年 5 月从考文垂和沃里克郡大学医院(UHCW)的尿液样本中分离出的肺炎克雷伯菌。UHCW 的患者曾在 QE 接受过治疗。我们在牛津纳米孔 R10.4.1 流式细胞上进行了长读全基因组测序,以便于比较完整的质粒序列。我们确定了 pQEB1 的结构变异,并定义了导致这些变异的分子事件。这些变异包括 IS26 介导的倒位以及多个插入序列和转座子的获得,包括汞或砷抗性基因的载体。我们发现,pQEB1 的一个特殊反转变体在 2023 年 11 月出现后与 QE 肝专科密切相关,但在 2024 年 1 月/2 月又在不同的专科和病房出现。迄今为止,该变体已出现在六名患者的五个不同细菌宿主中,这与该医院环境中最近和正在发生的 pQEB1 宿主间和患者间传播是一致的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
pQEB1: a hospital outbreak plasmid lineage carrying bla KPC-2.

While conducting genomic surveillance of carbapenemase-producing Enterobacteriaceae (CPE) from patient colonisation and clinical infections at Birmingham's Queen Elizabeth Hospital (QE), we identified an N-type plasmid lineage, pQEB1, carrying several antibiotic resistance genes, including the carbapenemase gene bla KPC-2. The pQEB1 lineage is concerning due to its conferral of multidrug resistance, its host range and apparent transmissibility, and its potential for acquiring further resistance genes. Representatives of pQEB1 were found in three sequence types (STs) of Citrobacter freundii, two STs of Enterobacter cloacae, and three species of Klebsiella. Hosts of pQEB1 were isolated from 11 different patients who stayed in various wards throughout the hospital complex over a 13 month period from January 2023 to February 2024. At present, the only representatives of the pQEB1 lineage in GenBank were carried by an Enterobacter hormaechei isolated from a blood sample at the QE in 2016 and a Klebsiella pneumoniae isolated from a urine sample at University Hospitals Coventry and Warwickshire (UHCW) in May 2023. The UHCW patient had been treated at the QE. Long-read whole-genome sequencing was performed on Oxford Nanopore R10.4.1 flow cells, facilitating comparison of complete plasmid sequences. We identified structural variants of pQEB1 and defined the molecular events responsible for them. These have included IS26-mediated inversions and acquisitions of multiple insertion sequences and transposons, including carriers of mercury or arsenic resistance genes. We found that a particular inversion variant of pQEB1 was strongly associated with the QE Liver speciality after appearing in November 2023, but was found in different specialities and wards in January/February 2024. That variant has so far been seen in five different bacterial hosts from six patients, consistent with recent and ongoing inter-host and inter-patient transmission of pQEB1 in this hospital setting.

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来源期刊
Microbial Genomics
Microbial Genomics Medicine-Epidemiology
CiteScore
6.60
自引率
2.60%
发文量
153
审稿时长
12 weeks
期刊介绍: Microbial Genomics (MGen) is a fully open access, mandatory open data and peer-reviewed journal publishing high-profile original research on archaea, bacteria, microbial eukaryotes and viruses.
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