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Importance of Surveillance of New Delhi Metallo-Beta-Lactamase Klebsiella pneumoniae: Molecular Characterization and Clonality of Strains Isolated in the Lazio Region, Italy
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-08 , DOI: 10.2147/idr.s318717 Martina Spaziante 1 , Carolina Venditti 2 , Ornella Butera 2 , Francesco Messina 2 , Antonino Di Caro 2 , Gilda Tonziello 1 , Simone Lanini 1 , Maria Adriana Cataldo 1 , Vincenzo Puro 1
Infection and Drug Resistance ( IF 2.9 ) Pub Date : 2021-09-08 , DOI: 10.2147/idr.s318717 Martina Spaziante 1 , Carolina Venditti 2 , Ornella Butera 2 , Francesco Messina 2 , Antonino Di Caro 2 , Gilda Tonziello 1 , Simone Lanini 1 , Maria Adriana Cataldo 1 , Vincenzo Puro 1
Affiliation
Introduction: New Delhi metallo-β-lactamase producing Klebsiella pneumoniae (NDM-Kpn) strains have been causing healthcare-associated infections worldwide. The aim of this study was to describe the molecular mechanisms of antimicrobial resistance and to analyze the clonality of NDM-Kpn isolates collected between January 2019 and June 2020 from patients admitted to hospitals from the Lazio region, Italy.
Methods: We performed a retrospective cohort study. Whole-genome sequencing (WGS) was performed on all NDM-Kpn strains; clonality and genetic relationships were further investigated.
Results: During the surveillance period, 17 NDM-Kpn isolates were obtained from 17 patients admitted to seven different hospitals. Eight different sequence types (STs) were detected: ST147 (n = 4), ST383 (n = 4), ST15 (n = 3), ST11 (n = 2), ST17 (n = 1), ST29 (n = 1), ST307 (n = 1) and the newly identified ST4853 (n = 1). Genetic relationships were further investigated by the WGS-based core genome MLST (cgMLST) scheme, and 5 cluster types (CTs) were identified. Whereas a substantial overall heterogeneity among isolates was detected (8 different STs were identified out of 17 isolates), the strains within each cluster showed a very high level of genome similarity.
Discussion: Our study highlights the key role of surveillance, which allowed taking a picture of a part of the NDM-Kpn strains circulating in Italy, adding further insight into their molecular features.
Keywords: carbapenem-resistant Klebsiella pneumoniae, New Delhi metallo-β-lactamase, surveillance, healthcare-associated infections
中文翻译：
新德里金属-β-内酰胺酶肺炎克雷伯菌监测的重要性：意大利拉齐奥地区分离菌株的分子特征和克隆性
简介：新德里产生金属-β-内酰胺酶的肺炎克雷伯菌(NDM-Kpn) 菌株已在全球范围内引起与医疗保健相关的感染。本研究的目的是描述抗菌素耐药性的分子机制，并分析 2019 年 1 月至 2020 年 6 月期间从意大利拉齐奥地区住院的患者中收集的 NDM-Kpn 分离株的克隆性。
方法：我们进行了一项回顾性队列研究。对所有 NDM-Kpn 菌株进行全基因组测序 (WGS)；进一步研究了克隆性和遗传关系。
结果：在监测期间，从 7 家不同医院收治的 17 名患者中获得了 17 株 NDM-Kpn 分离株。检测到八种不同的序列类型 (ST)：ST147 (n = 4)、ST383 (n = 4)、ST15 (n = 3)、ST11 (n = 2)、ST17 (n = 1)、ST29 (n = 1) )、ST307 (n = 1) 和新识别的 ST4853 (n = 1)。通过基于 WGS 的核心基因组 MLST (cgMLST) 方案进一步研究了遗传关系，并确定了 5 种簇类型 (CT)。尽管检测到分离株之间存在显着的总体异质性（从 17 个分离株中鉴定出 8 个不同的 ST），但每个簇内的菌株显示出非常高水平的基因组相似性。
讨论：我们的研究强调了监测的关键作用，它可以拍摄在意大利流行的部分 NDM-Kpn 菌株的照片，进一步了解它们的分子特征。
关键词：耐碳青霉烯类肺炎克雷伯菌，新德里金属-β-内酰胺酶，监测，医疗保健相关感染
更新日期：2021-09-07
Methods: We performed a retrospective cohort study. Whole-genome sequencing (WGS) was performed on all NDM-Kpn strains; clonality and genetic relationships were further investigated.
Results: During the surveillance period, 17 NDM-Kpn isolates were obtained from 17 patients admitted to seven different hospitals. Eight different sequence types (STs) were detected: ST147 (n = 4), ST383 (n = 4), ST15 (n = 3), ST11 (n = 2), ST17 (n = 1), ST29 (n = 1), ST307 (n = 1) and the newly identified ST4853 (n = 1). Genetic relationships were further investigated by the WGS-based core genome MLST (cgMLST) scheme, and 5 cluster types (CTs) were identified. Whereas a substantial overall heterogeneity among isolates was detected (8 different STs were identified out of 17 isolates), the strains within each cluster showed a very high level of genome similarity.
Discussion: Our study highlights the key role of surveillance, which allowed taking a picture of a part of the NDM-Kpn strains circulating in Italy, adding further insight into their molecular features.
Keywords: carbapenem-resistant Klebsiella pneumoniae, New Delhi metallo-β-lactamase, surveillance, healthcare-associated infections
中文翻译：
新德里金属-β-内酰胺酶肺炎克雷伯菌监测的重要性：意大利拉齐奥地区分离菌株的分子特征和克隆性
简介：新德里产生金属-β-内酰胺酶的肺炎克雷伯菌(NDM-Kpn) 菌株已在全球范围内引起与医疗保健相关的感染。本研究的目的是描述抗菌素耐药性的分子机制，并分析 2019 年 1 月至 2020 年 6 月期间从意大利拉齐奥地区住院的患者中收集的 NDM-Kpn 分离株的克隆性。
方法：我们进行了一项回顾性队列研究。对所有 NDM-Kpn 菌株进行全基因组测序 (WGS)；进一步研究了克隆性和遗传关系。
结果：在监测期间，从 7 家不同医院收治的 17 名患者中获得了 17 株 NDM-Kpn 分离株。检测到八种不同的序列类型 (ST)：ST147 (n = 4)、ST383 (n = 4)、ST15 (n = 3)、ST11 (n = 2)、ST17 (n = 1)、ST29 (n = 1) )、ST307 (n = 1) 和新识别的 ST4853 (n = 1)。通过基于 WGS 的核心基因组 MLST (cgMLST) 方案进一步研究了遗传关系，并确定了 5 种簇类型 (CT)。尽管检测到分离株之间存在显着的总体异质性（从 17 个分离株中鉴定出 8 个不同的 ST），但每个簇内的菌株显示出非常高水平的基因组相似性。
讨论：我们的研究强调了监测的关键作用，它可以拍摄在意大利流行的部分 NDM-Kpn 菌株的照片，进一步了解它们的分子特征。
关键词：耐碳青霉烯类肺炎克雷伯菌，新德里金属-β-内酰胺酶，监测，医疗保健相关感染
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