본문 바로가기
KERD
논문KCI 등재

Extensively Drug-Resistant Escherichia coli Sequence Type 1642 Carrying an IncX3 Plasmid Containing the blaKPC-2 Gene Associated with Transposon Tn4401a

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류병리학

초록

Background: Extensively drug-resistant (XDR) Enterobacteriaceae carrying the blaKPC gene have emerged as a major global therapeutic concern. The purpose of this study was to analyze the complete sequences of plasmids from KPC-2 carbapenemase-producing XDR Escherichia coli sequence type (ST) 1642 isolates. Methods: We performed antimicrobial susceptibility testing, PCR, multilocus sequence typing (MLST), and whole-genome sequencing to characterize the plasmid-mediated KPC- 2-producing E. coli clinical isolates. Results: The isolates were resistant to most available antibiotics, including meropenem, ampicillin, ceftriaxone, gentamicin, and ciprofloxacin, but susceptible to tigecycline and colistin. The isolates were identified as the rare ST1642 by MLST. The isolates carried four plasmids: the first 69-kb conjugative IncX3 plasmid harbors blaKPC-2 within a truncated Tn4401a transposon and blaSHV-11 with duplicated conjugative elements. The second 142-kb plasmid with a multireplicon consisting of IncQ, IncFIA, and IncIB carries blaTEM-1b and two class 1 integrons. This plasmid also harbors a wide variety of additional antimicrobial resistance genes including aadA5, dfrA17, mph(A), sul1, tet(B), aac(3’)-IId, strA, strB, and sul2. Conclusions: The complete sequence analysis of plasmids from an XDR E. coli strain related to persistent infection showed the coexistence of a blaKPC-2–carrying IncX3-type plasmid and a class 1 integron-harboring multireplicon, suggesting its potential to cause outbreaks. Of additional clinical significance, the rare ST1642, identified in a cat, could constitute the source of human infection.

Abstract

Background: Extensively drug-resistant (XDR) Enterobacteriaceae carrying the blaKPC gene have emerged as a major global therapeutic concern. The purpose of this study was to analyze the complete sequences of plasmids from KPC-2 carbapenemase-producing XDR Escherichia coli sequence type (ST) 1642 isolates. Methods: We performed antimicrobial susceptibility testing, PCR, multilocus sequence typing (MLST), and whole-genome sequencing to characterize the plasmid-mediated KPC- 2-producing E. coli clinical isolates. Results: The isolates were resistant to most available antibiotics, including meropenem, ampicillin, ceftriaxone, gentamicin, and ciprofloxacin, but susceptible to tigecycline and colistin. The isolates were identified as the rare ST1642 by MLST. The isolates carried four plasmids: the first 69-kb conjugative IncX3 plasmid harbors blaKPC-2 within a truncated Tn4401a transposon and blaSHV-11 with duplicated conjugative elements. The second 142-kb plasmid with a multireplicon consisting of IncQ, IncFIA, and IncIB carries blaTEM-1b and two class 1 integrons. This plasmid also harbors a wide variety of additional antimicrobial resistance genes including aadA5, dfrA17, mph(A), sul1, tet(B), aac(3’)-IId, strA, strB, and sul2. Conclusions: The complete sequence analysis of plasmids from an XDR E. coli strain related to persistent infection showed the coexistence of a blaKPC-2–carrying IncX3-type plasmid and a class 1 integron-harboring multireplicon, suggesting its potential to cause outbreaks. Of additional clinical significance, the rare ST1642, identified in a cat, could constitute the source of human infection.

참고문헌 (20)

  1. Lee CR, "Global dissemination of carbapenemase-producing Klebsiella pneumoniae: epidemiology, genetic Context, treatment options, and detection methods", Front Microbiol, 7, pp.895~ (2016)
  2. Chen YT, "KPC-2-encoding plasmids from Escherichia coli and Klebsiella pneumoniae in Taiwan", J Antimicrob Chemother, 69, pp.628~631 (2014)[DOI]
  3. Adler A, "A multicenter study of the clonal structure and resistance mechanism of KPC-producing Escherichia coli isolates in Israel", Clin Microbiol Infect, 21, pp.230~235 (2015)[DOI]
  4. Piazza A, "Emergence of Escherichia coli Sequence Type 131 (ST131) and ST3948 with KPC-2, KPC-3 and KPC-8 carbapenemases from a Long-Term Care and Rehabilitation Facility (LTCRF) in Northern Italy", Adv Exp Med Biol, 901, pp.77~89 (2016)
  5. Chavda KD, "Molecular diversity and plasmid analysis of KPC-producing Escherichia coli", Antimicrob Agents Chemother, 60, pp.4073~4081 (2016)[DOI]
  6. Xu G, "Emergence of KPC-2-producing Escherichia coli isolates in an urban river in Harbin, China", World J Microbiol Biotechnol, 31, pp.1443~1450 (2015)[DOI]
  7. Johnson TJ, "Expansion of the IncX plasmid family for improved identification and typing of novel plasmids in drug-resistant Enterobacteriaceae", Plasmid, 68, pp.43~50 (2012)[DOI]
  8. He S, "Mechanisms of evolution in high-consequence drug resistance plasmids", MBio, 7, pp.e01987~16 (2016)
  9. Naas T, "Genetic structures at the origin of acquisition of the <TEX>${\beta}$<", TEX>-lactamase <TEX>$bla_{KPC}$<, Antimicrob Agents Chemother, pp.2008, 52[DOI]
  10. Naas T, "Role of ISKpn7 and deletions in <TEX>$bla_{KPC}$<", TEX> gene expression, 2012, pp.56, 4753~4759
  11. National Committee for Clinical Laboratory Standards, "Performance standards for antimicrobial susceptibility testing. Twenty-sixth informational supplement, M100-S26", National Committee for Clinical Laboratory Standards, ~ (2016)
  12. Kim MN, "Nosocomial clustering of NDM-1-producing Klebsiella pneumoniae sequence type 340 strains in four patients at a South Korean tertiary care hospital", J Clin Microbiol, 50, pp.1433~1436 (2012)[DOI]
  13. Chen L, "Multiplex real-time PCR assay for detection and classification of Klebsiella pneumoniae carbapenemase gene (blaKPC) variants", J Clin Microbiol, 49, pp.579~585 (2011)[DOI]
  14. Jeong S, "Evaluation of peptide nucleic acid-mediated multiplex real-time PCR kits for rapid detection of carbapenemase genes in gram-negative clinical isolates", J Microbiol Methods, 113, pp.4~9 (2015)[DOI]
  15. Jeong SH, "Clonal and horizontal spread of the <TEX>$bla_{OXA-232}$<", TEX> gene among Enterobacteriaceae in a Korean hospital, 2015, pp.82, 70~72
  16. Harada K, "Mechanisms of resistance to cephalosporin and emergence of O25b-ST131 clone harboring CTX-M-27 <TEX>${\beta}$<", TEX>-lactamase in extraintestinal pathogenic Escherichia coli from dogs and cats in Japan, 2012, pp.56, 480~485
  17. O'Hara JA, "Molecular epidemiology of KPC-producing Escherichia coli: occurrence of ST131-fimH30 subclone harboring pKpQIL-like IncFIIk plasmid", Antimicrob Agents Chemother, 58, pp.4234~4237 (2014)[DOI]
  18. Kim JO, "Outbreak of KPC-2-producing Enterobacteriaceae caused by clonal dissemination of Klebsiella pneumoniae ST307 carrying an IncX3-type plasmid harboring a truncated Tn4401a", Diagn Microbiol Infect Dis, 87, pp.343~348 (2017)[DOI]
  19. Kassis-Chikhani N, "Complete nucleotide sequence of the first KPC-2- and SHV-12-encoding IncX plasmid, pKpS90, from Klebsiella pneumoniae", Antimicrob Agents Chemother, 57, pp.618~620 (2013)[DOI]
  20. Plante I, "Direct sequencing and PCR mapping of integrons reveals multiple class 1 integrons in the multiresistant strain Enterobacter cloacae SCH88040794", FEMS Microbiol Lett, 221, pp.59~62 (2003)[DOI]

관련 논문AI추천

Antimicrobial Resistance Caused by KPC-2 Encoded by Promiscuous Plasmids of the Klebsiella pneumoniae ST307 StrainChoi Tae-Jin, Lee Miyoung대한진단검사의학회 · Annals of Laboratory Medicine2021 · 제41권 제1호Molecular Analysis of Carbapenem-Resistant Enterobacteriaceae at a South Korean Hospital이미영, 최태진한국미생물·생명공학회 · 한국미생물·생명공학회지2020 · 제48권 제3호Multidrug Resistance Mechanisms of Carbapenem Resistant Klebsiella pneumoniae Strains Isolated in Chongqing, ChinaJing Shi, Jinrong Yan, Liping Zhang, Shan Sun, Shuangshuang Yang, Shuli Pu, Xiaojiong Jia, XiuYu Xu대한진단검사의학회 · Annals of Laboratory Medicine2017 · 제37권 제5호Risk factors and molecular epidemiology of community-onset, multidrug resistance extended-spectrum β-lactamase-producing Escherichia coli infections강철인, 박소연, 백경란, 송재훈, 위유미, 이남용, 정두련대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제1호MCR1 and KPC2 Co-producing Klebsiella pneumoniae Bacteremia: First Case in Korea권기태, 박지영, 송도영, 이광준, 최지애, 허상택대한감염학회 · Infection and Chemotherapy2019 · 제51권 제4호Distribution of β-Lactamase Genes Among Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated From Patients in TurkeyAnton Y. Peleg, Ayşegül Çopur Çiçek, Ayşegül Saral, Azer Özad Düzgün, Cemal Sandallı, Fatih Şaban Beriş, Hakan Karaoğlu, Mehmet Ziya Doymaz, Meryem Iraz, Osman Birol Özgümüş, Yasemin Akkoyunlu대한진단검사의학회 · Annals of Laboratory Medicine2015 · 제35권 제6호

이 간행물의 다른 논문 (16건)