{"title":"鉴定肺炎克雷伯菌中与头孢他啶-阿维菌素耐药性相关的 blaKPC-90，以及由 IS26 介导的耐药基因的易位和截断。","authors":"Weiwei Yang, Heping Xu, Yuanxun Zhao, Wannan Chen, Xiaobo Ma, Fupin Hu","doi":"10.1016/j.ijantimicag.2024.107388","DOIUrl":null,"url":null,"abstract":"<p><p>In this study, we discovered bla<sub>KPC-90</sub> in ceftazidime-avibactam resistant clinical isolates of K. pneumoniae from a patient with multiple comorbidities. KPC-90 isolates had an insertion of two amino acids (Thr180_Ser181 ins Tyr Thr) compared to the wildtype KPC-2. Antimicrobial susceptibility testing of isolates with KPC-90 vs. KPC-2 showed ceftazidime-avibactam MICs of >128 vs. 1-2 mg/L, meropenem-vaborbactam MICs of 4 vs. 1 mg/L, meropenem MICs of 4-8 vs. >128 mg/L and imipenem MICs of 0.5-1 vs. 64 mg/L. Analysis of kinetic parameters of KPC-90 compared to KPC-2 showed decreased hydrolysis of carbapenems and increased IC50 of avibactam. Genetic characterization of the plasmid revealed that IS26 could mediate the intramolecular inversion, translocation and truncation of the resistance determinant region.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107388"},"PeriodicalIF":4.9000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Identification of bla<sub>KPC-90</sub> in Klebsiella pneumoniae associated with ceftazidime-avibactam resistance and the translocation & truncation of resistant genes mediated by IS26.\",\"authors\":\"Weiwei Yang, Heping Xu, Yuanxun Zhao, Wannan Chen, Xiaobo Ma, Fupin Hu\",\"doi\":\"10.1016/j.ijantimicag.2024.107388\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In this study, we discovered bla<sub>KPC-90</sub> in ceftazidime-avibactam resistant clinical isolates of K. pneumoniae from a patient with multiple comorbidities. KPC-90 isolates had an insertion of two amino acids (Thr180_Ser181 ins Tyr Thr) compared to the wildtype KPC-2. Antimicrobial susceptibility testing of isolates with KPC-90 vs. KPC-2 showed ceftazidime-avibactam MICs of >128 vs. 1-2 mg/L, meropenem-vaborbactam MICs of 4 vs. 1 mg/L, meropenem MICs of 4-8 vs. >128 mg/L and imipenem MICs of 0.5-1 vs. 64 mg/L. Analysis of kinetic parameters of KPC-90 compared to KPC-2 showed decreased hydrolysis of carbapenems and increased IC50 of avibactam. Genetic characterization of the plasmid revealed that IS26 could mediate the intramolecular inversion, translocation and truncation of the resistance determinant region.</p>\",\"PeriodicalId\":13818,\"journal\":{\"name\":\"International Journal of Antimicrobial Agents\",\"volume\":\" \",\"pages\":\"107388\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Antimicrobial Agents\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ijantimicag.2024.107388\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Antimicrobial Agents","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijantimicag.2024.107388","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
在本研究中，我们在一名患有多种并发症的患者的头孢他啶-阿维菌素耐药肺炎克菌临床分离株中发现了 blaKPC-90。与野生型 KPC-2 相比，KPC-90 分离物插入了两个氨基酸（Thr180_Ser181 ins Tyr Thr）。对 KPC-90 与 KPC-2 分离物进行的抗菌药物敏感性检测显示，头孢唑肟-阿维巴坦的 MIC 为大于 128 mg/L 与 1-2 mg/L，美罗培南-瓦巴拉坦的 MIC 为 4 mg/L 与 1 mg/L，美罗培南的 MIC 为 4-8 mg/L 与大于 128 mg/L，亚胺培南的 MIC 为 0.5-1 mg/L 与 64 mg/L。与 KPC-2 相比，KPC-90 的动力学参数分析表明碳青霉烯类的水解作用降低，阿维巴坦的 IC50 增加。质粒的遗传特性分析表明，IS26 可介导分子内反转、易位和耐药性决定区的截断。
Identification of blaKPC-90 in Klebsiella pneumoniae associated with ceftazidime-avibactam resistance and the translocation & truncation of resistant genes mediated by IS26.
In this study, we discovered blaKPC-90 in ceftazidime-avibactam resistant clinical isolates of K. pneumoniae from a patient with multiple comorbidities. KPC-90 isolates had an insertion of two amino acids (Thr180_Ser181 ins Tyr Thr) compared to the wildtype KPC-2. Antimicrobial susceptibility testing of isolates with KPC-90 vs. KPC-2 showed ceftazidime-avibactam MICs of >128 vs. 1-2 mg/L, meropenem-vaborbactam MICs of 4 vs. 1 mg/L, meropenem MICs of 4-8 vs. >128 mg/L and imipenem MICs of 0.5-1 vs. 64 mg/L. Analysis of kinetic parameters of KPC-90 compared to KPC-2 showed decreased hydrolysis of carbapenems and increased IC50 of avibactam. Genetic characterization of the plasmid revealed that IS26 could mediate the intramolecular inversion, translocation and truncation of the resistance determinant region.
期刊介绍：
The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.
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