Genomic Analysis of Carbapenemase - Producing Extensively Drug-Resistant Klebsiella pneumoniae Isolates Reveals the Horizontal Spread of p18-43_01 Plasmid Encoding bla NDM-1 in South Africa.

Autor: Ramsamy Y; Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.; Medical Microbiology, National Health Laboratory Services, Durban 4000, South Africa.; Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Mlisana KP; Medical Microbiology, National Health Laboratory Services, Durban 4000, South Africa.; Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Allam M; Sequencing Core Facility, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2131, South Africa., Amoako DG; Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Abia ALK; Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Ismail A; Sequencing Core Facility, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg 2131, South Africa., Singh R; Medical Microbiology, National Health Laboratory Services, Durban 4000, South Africa.; Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Kisten T; School of Clinical Medicine, Discipline of Anaesthetics & Critical Care, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.; Inkosi Albert Luthuli Central Hospital, Department of Critical Care, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Han KS; Medical Microbiology, National Health Laboratory Services, Durban 4000, South Africa.; Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Muckart DJJ; Inkosi Albert Luthuli Central Hospital, Department of Surgery & Trauma Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Hardcastle T; Inkosi Albert Luthuli Central Hospital, Department of Surgery & Trauma Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa., Suleman M; Ahmed Al-Kadi Private Hospital, Durban 4000, South Africa., Essack SY; Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
Jazyk: angličtina
Zdroj: Microorganisms [Microorganisms] 2020 Jan 17; Vol. 8 (1). Date of Electronic Publication: 2020 Jan 17.
DOI: 10.3390/microorganisms8010137
Abstrakt: Whole-genome sequence (WGS) analyses were employed to investigate the genomic epidemiology of extensively drug-resistant Klebsiella pneumoniae strains, focusing on the carbapenem resistance-encoding determinants, mobile genetic support, clonal and epidemiological relationships. A total of ten isolates were obtained from patients admitted to the intensive care unit (ICU) in a public hospital in South Africa. Five isolates were from rectal swabs of colonized patients and five from blood cultures of patients with invasive carbapenem-resistant infections. Following microbial identification and antibiotic susceptibility tests, the isolates were subjected to WGS on the Illumina MiSeq platform. All the isolates showed genotypic resistance to tested β-lactams (NDM-1, OXA-1, CTX-M-15, TEM-1B, SHV-1) and other antibiotics. All but one isolate belonged to the ST152 with a novel sequence type, ST3136, differing by a single-locus variant. The isolates had the same plasmid multilocus sequence type (IncF[K12:A-:B36]) and capsular serotype ( KL149 ), supporting the epidemiological linkage between the clones. Resistance to carbapenems in the 10 isolates was conferred by the bla NDM-1 mediated by the acquisition of multi-replicon [ColRNAI, IncFIB(pB171), Col440I, IncFII, IncFIB(K) and IncFII(Yp)] p18-43_01 plasmid. These findings suggest that the acquisition of bla NDM-1 -bearing plasmid structure (p18-43_01), horizontal transfer and clonal dissemination facilitate the spread of carbapenemases in South Africa. This emphasizes the importance of targeted infection control measures to prevent dissemination.
Competing Interests: Sabiha Y. Essack is chairperson of the Global Respiratory Infection Partnership sponsored by an unconditional education grant from Reckitt and Benckiser. All other authors declare no competing interests.
Databáze: MEDLINE
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