越南南部儿童腹泻病例分离的肺炎克雷伯菌出现mcr-8.2介导的粘菌素耐药性

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance Pub Date : 2025-02-21 DOI:10.1016/j.jgar.2025.02.007

Nga Thi Le , Phuong Hoai Hoang , Quynh Nguyen , Minh Nhat Ha Truong , Chinh Van Dang , Tinh Huu Ho , Phuc Le Hoang , Dinh Quang Truong , Ha Thi Thanh Nguyen , Chuong Van Le , Trang Thi Phuong Phan

{"title":"越南南部儿童腹泻病例分离的肺炎克雷伯菌出现mcr-8.2介导的粘菌素耐药性","authors":"Nga Thi Le , Phuong Hoai Hoang , Quynh Nguyen , Minh Nhat Ha Truong , Chinh Van Dang , Tinh Huu Ho , Phuc Le Hoang , Dinh Quang Truong , Ha Thi Thanh Nguyen , Chuong Van Le , Trang Thi Phuong Phan","doi":"10.1016/j.jgar.2025.02.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Colistin resistance poses a growing global challenge, particularly in low- and middle-income countries where antibiotic misuse is prevalent. This study investigates the prevalence of colistin resistance in <em>Klebsiella</em> spp. and characterizes the genetic features of resistant isolates, focusing on the <em>mcr-8.2</em> gene identified in a <em>Klebsiella pneumoniae</em> isolate from pediatric diarrheal cases in southern Vietnam.</div></div><div><h3>Methods</h3><div>Stool samples were collected from 500 pediatric patients (aged 0–5 years) hospitalized with diarrhea in two tertiary hospitals in Ho Chi Minh City between March and September 2022. Samples were cultured on Violet Red Bile Glucose Agar, then presumptive <em>Klebsiella</em> spp. colonies were selected, purified on nutrient agar, and identified using MALDI-TOF MS. Colistin resistance was determined via minimum inhibitory concentration testing, and the presence of <em>mcr</em> genes was confirmed through polymerase chain reaction. Whole-genome sequencing was performed on the <em>Klebsiella pneumoniae</em> strain harboring <em>mcr-8.2</em> to elucidate resistance mechanisms. Strain characterization was performed using multi-locus sequence typing, while conjugation experiments assessed horizontal gene transfer potential.</div></div><div><h3>Results</h3><div>Among 121 <em>Klebsiella</em> spp. isolates, 49 (40.5%) were resistant to colistin. The <em>mcr-1</em> gene was detected in 31 isolates (25.6%), whereas the <em>mcr-8</em> was identified in a single isolate (0.8%), with a colistin MIC of 16 µg/mL. Genomic analysis revealed 34 antibiotic resistance genes, including <em>mcr-8.2</em> and multiple β-lactamase genes, alongside plasmid types IncFIB and IncFII. Chromosomal mutations in <em>phoP, phoQ</em>, and <em>lpxM</em> were also implicated in colistin resistance.</div></div><div><h3>Conclusions</h3><div>This study documents the emergence of <em>mcr-8.2</em>-mediated colistin resistance in K<em>. pneumoniae</em> from pediatric diarrhea in Vietnam and highlights a high prevalence of multidrug resistance in <em>Klebsiella</em> spp.. Continuous surveillance of <em>mcr</em> genes and novel therapeutic strategies are urgently needed.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 120-126"},"PeriodicalIF":3.7000,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Emergence of mcr-8.2-mediated colistin resistance in Klebsiella pneumoniae isolated from pediatric diarrhea cases in southern Vietnam\",\"authors\":\"Nga Thi Le , Phuong Hoai Hoang , Quynh Nguyen , Minh Nhat Ha Truong , Chinh Van Dang , Tinh Huu Ho , Phuc Le Hoang , Dinh Quang Truong , Ha Thi Thanh Nguyen , Chuong Van Le , Trang Thi Phuong Phan\",\"doi\":\"10.1016/j.jgar.2025.02.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Colistin resistance poses a growing global challenge, particularly in low- and middle-income countries where antibiotic misuse is prevalent. This study investigates the prevalence of colistin resistance in <em>Klebsiella</em> spp. and characterizes the genetic features of resistant isolates, focusing on the <em>mcr-8.2</em> gene identified in a <em>Klebsiella pneumoniae</em> isolate from pediatric diarrheal cases in southern Vietnam.</div></div><div><h3>Methods</h3><div>Stool samples were collected from 500 pediatric patients (aged 0–5 years) hospitalized with diarrhea in two tertiary hospitals in Ho Chi Minh City between March and September 2022. Samples were cultured on Violet Red Bile Glucose Agar, then presumptive <em>Klebsiella</em> spp. colonies were selected, purified on nutrient agar, and identified using MALDI-TOF MS. Colistin resistance was determined via minimum inhibitory concentration testing, and the presence of <em>mcr</em> genes was confirmed through polymerase chain reaction. Whole-genome sequencing was performed on the <em>Klebsiella pneumoniae</em> strain harboring <em>mcr-8.2</em> to elucidate resistance mechanisms. Strain characterization was performed using multi-locus sequence typing, while conjugation experiments assessed horizontal gene transfer potential.</div></div><div><h3>Results</h3><div>Among 121 <em>Klebsiella</em> spp. isolates, 49 (40.5%) were resistant to colistin. The <em>mcr-1</em> gene was detected in 31 isolates (25.6%), whereas the <em>mcr-8</em> was identified in a single isolate (0.8%), with a colistin MIC of 16 µg/mL. Genomic analysis revealed 34 antibiotic resistance genes, including <em>mcr-8.2</em> and multiple β-lactamase genes, alongside plasmid types IncFIB and IncFII. Chromosomal mutations in <em>phoP, phoQ</em>, and <em>lpxM</em> were also implicated in colistin resistance.</div></div><div><h3>Conclusions</h3><div>This study documents the emergence of <em>mcr-8.2</em>-mediated colistin resistance in K<em>. pneumoniae</em> from pediatric diarrhea in Vietnam and highlights a high prevalence of multidrug resistance in <em>Klebsiella</em> spp.. Continuous surveillance of <em>mcr</em> genes and novel therapeutic strategies are urgently needed.</div></div>\",\"PeriodicalId\":15936,\"journal\":{\"name\":\"Journal of global antimicrobial resistance\",\"volume\":\"42 \",\"pages\":\"Pages 120-126\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-02-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of global antimicrobial resistance\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213716525000438\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of global antimicrobial resistance","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213716525000438","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

摘要

背景：粘菌素耐药性构成了日益严峻的全球挑战，特别是在抗生素滥用普遍存在的低收入和中等收入国家。本研究调查了克雷伯菌对粘菌素的耐药性，并分析了耐药菌株的遗传特征，重点研究了从越南南部儿童腹泻病例中分离出的肺炎克雷伯菌的mcr-8.2基因。方法：收集2022年3月至9月在胡志明市两所三级医院住院的500例0-5岁腹泻患儿的粪便样本。在紫红胆汁葡萄糖琼脂上培养样品，选择克雷伯氏菌菌落，在营养琼脂上纯化，用MALDI-TOF ms进行鉴定，通过最低抑制浓度测试确定粘菌素耐药性，通过聚合酶链反应确定mcr基因的存在。对携带mcr-8.2的肺炎克雷伯菌进行全基因组测序，以阐明耐药机制。菌株鉴定采用多位点序列分型，结合实验评估水平基因转移潜力。结果：121株克雷伯菌对粘菌素耐药49株（40.5%）；31株（25.6%）分离到mcr-1基因，1株（0.8%）分离到mcr-8基因，黏菌素MIC为16µg/mL。基因组分析显示34个抗生素耐药基因，包括mcr-8.2和多个β-内酰胺酶基因，以及质粒类型IncFIB和IncFII。phoP、phoQ和lpxM的染色体突变也与粘菌素耐药有关。结论：本研究记录了越南儿童腹泻肺炎克雷伯氏菌中mcr-8.2介导的粘菌素耐药的出现，并强调了克雷伯氏菌中多药耐药的高发。对mcr基因的持续监测和新的治疗策略是迫切需要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Emergence of mcr-8.2-mediated colistin resistance in Klebsiella pneumoniae isolated from pediatric diarrhea cases in southern Vietnam

Background

Colistin resistance poses a growing global challenge, particularly in low- and middle-income countries where antibiotic misuse is prevalent. This study investigates the prevalence of colistin resistance in Klebsiella spp. and characterizes the genetic features of resistant isolates, focusing on the mcr-8.2 gene identified in a Klebsiella pneumoniae isolate from pediatric diarrheal cases in southern Vietnam.

Methods

Stool samples were collected from 500 pediatric patients (aged 0–5 years) hospitalized with diarrhea in two tertiary hospitals in Ho Chi Minh City between March and September 2022. Samples were cultured on Violet Red Bile Glucose Agar, then presumptive Klebsiella spp. colonies were selected, purified on nutrient agar, and identified using MALDI-TOF MS. Colistin resistance was determined via minimum inhibitory concentration testing, and the presence of mcr genes was confirmed through polymerase chain reaction. Whole-genome sequencing was performed on the Klebsiella pneumoniae strain harboring mcr-8.2 to elucidate resistance mechanisms. Strain characterization was performed using multi-locus sequence typing, while conjugation experiments assessed horizontal gene transfer potential.

Results

Among 121 Klebsiella spp. isolates, 49 (40.5%) were resistant to colistin. The mcr-1 gene was detected in 31 isolates (25.6%), whereas the mcr-8 was identified in a single isolate (0.8%), with a colistin MIC of 16 µg/mL. Genomic analysis revealed 34 antibiotic resistance genes, including mcr-8.2 and multiple β-lactamase genes, alongside plasmid types IncFIB and IncFII. Chromosomal mutations in phoP, phoQ, and lpxM were also implicated in colistin resistance.

Conclusions

This study documents the emergence of mcr-8.2-mediated colistin resistance in K. pneumoniae from pediatric diarrhea in Vietnam and highlights a high prevalence of multidrug resistance in Klebsiella spp.. Continuous surveillance of mcr genes and novel therapeutic strategies are urgently needed.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

8.70

自引率

2.20%

发文量

285

审稿时长

34 weeks

期刊介绍： The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.