Bacterial carbapenem resistance, especially when mediated by transferable carbapenemases, is of important public health concern. An increased number of metallo-β-lactamase (MBL)-producing Klebsiella pneumoniae strains isolated in a tertiary hospital in Thessaloniki, Greece, called for further genetic investigation.The study included 29 non-repetitive carbapenem resistant K. pneumoniae isolates phenotypically characterized as MBL-producers collected in a tertiary hospital in Greece. The isolates were screened for the detection of carbapenemase genes (K. pneumoniae carbapenemase (blaKPC), Verona-integron-encoded MBL-1 (blaVIM-1), imipenemase (blaIMP), oxacillinase-48 (blaOXA-48) and New Delhi MBL (blaNDM)). The genetic relationship of the isolates was determined by Random Amplified Polymorphic DNA (RAPD) analysis. The whole genome sequences (WGS) from two NDM-positive K. pneumoniae isolates were further characterized.The presence of New Delhi MBL (blaNDM) gene was confirmed in all K. pneumoniae isolates, while blaKPC and blaVIM-1 genes were co-detected in one and two isolates, respectively. The RAPD analysis showed that the isolates were clustered into two groups. The whole genome sequence analysis of two K. pneumoniae isolates revealed that they belonged to the sequence type 11, they carried the blaNDM-1 gene, and exhibited differences in the number and type of the plasmids and the resistant genes.All MBL-producing K. pneumoniae isolates of the study harbored a blaNDM gene, while WGS analysis revealed genetic diversity in resistance genes. Continuous surveillance is needed to detect the emergence of new clones in a hospital setting, while application of antimicrobial stewardship is the only way to reduce the spread of multi-resistant bacteria.

中文翻译：

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产生 NDM 的肺炎克雷伯菌在希腊一家三级医院传播。


细菌碳青霉烯类耐药性，尤其是由可转移碳青霉烯酶介导的耐药性，是重要的公共卫生问题。希腊塞萨洛尼基一家三级医院分离出的产生金属-β-内酰胺酶 (MBL) 的肺炎克雷伯菌菌株数量有所增加，需要进一步进行基因研究。该研究包括 29 种表型特征为 MBL 的非重复碳青霉烯类耐药肺炎克雷伯菌分离株- 生产者在希腊的一家三级医院收集。对分离株进行碳青霉烯酶基因检测筛选（肺炎克雷伯菌碳青霉烯酶（blaKPC）、维罗纳整合子编码的MBL-1（blaVIM-1）、亚胺青霉酶（blaIMP）、苯唑西林酶-48（blaOXA-48）和新德里MBL （blaNDM））。通过随机扩增多态性 DNA (RAPD) 分析确定分离株的遗传关系。对两个 NDM 阳性肺炎克雷伯菌分离株的全基因组序列 (WGS) 进行了进一步表征。所有肺炎克雷伯菌分离株均证实存在 New Delhi MBL (blaNDM) 基因，同时同时检测到 blaKPC 和 blaVIM-1 基因分别在一个和两个分离株中。 RAPD 分析显示分离株分为两组。两株肺炎克雷伯菌全基因组序列分析显示，它们属于序列类型11，携带blaNDM-1基因，且质粒数量和类型以及耐药基因存在差异。所有产MBL肺炎克雷伯菌该研究的肺炎链球菌分离株含有 blaNDM 基因，而全基因组测序分析揭示了耐药基因的遗传多样性。需要持续监测以检测医院环境中新克隆的出现，而应用抗菌药物管理是减少多重耐药细菌传播的唯一方法。