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Abstract：
UNASSIGNED: This study aimed to investigate the emergence and characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains that demonstrate resistance to multiple antibiotics, including aminoglycosides and tigecycline, in a Chinese hospital.
UNASSIGNED: A group of ten CRKP strains were collected from the nine patients in a Chinese hospital. Antimicrobial Susceptibility Testing (AST) and phenotypic inhibition assays precisely assess bacterial antibiotic resistance. Real-time quantitative PCR (RT-qPCR) was used to analyze the mRNA levels of efflux pump genes (acrA/acrB and oqxA/oqxB) and the regulatory gene (ramA). The core-genome tree and PFGE patterns were analyzed to assess the clonal and horizontal transfer expansion of the strains. Whole-genome sequencing was performed on a clinical isolate of K. pneumoniae named Kpn20 to identify key resistance genes and antimicrobial resistance islands (ARI).
UNASSIGNED: The CRKP strains showed high resistance to carbapenems, aminoglycosides (CLSI, 2024), and tigecycline (EUCAST, 2024). The mRNA expression levels of efflux pump genes and regulatory genes were detected by RT-qPCR. All 10 isolates had significant differences compared to the control group of ATCC13883. The core-genome tree and PFGE patterns revealed five clusters, indicating clonal and horizontal transfer expansion. Three key resistance genes (blaoxa-232, blaCTX-M-15 , and rmtF) were observed in the K. pneumoniae clinical isolate Kpn20. Mobile antibiotic resistance islands were identified containing bla CTX-M-15 and rmtF, with multiple insertion sequences and transposons present. The coexistence of bla oxa-232 and rmtF in a high-risk K. pneumoniae strain was reported. Conjugation assay was utilized to investigate the transferability of bla oxa-232-encoding plasmids horizontally.
UNASSIGNED: The study highlights the emergence of ST15-KL112 high-risk CRKP strains with multidrug resistance, including to aminoglycosides and tigecycline. The presence of mobile ARI and clonal and horizontal transfer expansion of strains indicate the threat of transmission of these strains. Future research is needed to assess the prevalence of such isolates and develop effective control measures.
UNASSIGNED: A group of ten CRKP strains were collected from the nine patients in a Chinese hospital. Antimicrobial Susceptibility Testing (AST) and phenotypic inhibition assays precisely assess bacterial antibiotic resistance. Real-time quantitative PCR (RT-qPCR) was used to analyze the mRNA levels of efflux pump genes (acrA/acrB and oqxA/oqxB) and the regulatory gene (ramA). The core-genome tree and PFGE patterns were analyzed to assess the clonal and horizontal transfer expansion of the strains. Whole-genome sequencing was performed on a clinical isolate of K. pneumoniae named Kpn20 to identify key resistance genes and antimicrobial resistance islands (ARI).
UNASSIGNED: The CRKP strains showed high resistance to carbapenems, aminoglycosides (CLSI, 2024), and tigecycline (EUCAST, 2024). The mRNA expression levels of efflux pump genes and regulatory genes were detected by RT-qPCR. All 10 isolates had significant differences compared to the control group of ATCC13883. The core-genome tree and PFGE patterns revealed five clusters, indicating clonal and horizontal transfer expansion. Three key resistance genes (blaoxa-232, blaCTX-M-15 , and rmtF) were observed in the K. pneumoniae clinical isolate Kpn20. Mobile antibiotic resistance islands were identified containing bla CTX-M-15 and rmtF, with multiple insertion sequences and transposons present. The coexistence of bla oxa-232 and rmtF in a high-risk K. pneumoniae strain was reported. Conjugation assay was utilized to investigate the transferability of bla oxa-232-encoding plasmids horizontally.
UNASSIGNED: The study highlights the emergence of ST15-KL112 high-risk CRKP strains with multidrug resistance, including to aminoglycosides and tigecycline. The presence of mobile ARI and clonal and horizontal transfer expansion of strains indicate the threat of transmission of these strains. Future research is needed to assess the prevalence of such isolates and develop effective control measures.
摘要：
■本研究旨在调查耐碳青霉烯类肺炎克雷伯菌（CRKP）菌株的出现和特征，这些菌株对多种抗生素具有耐药性，包括氨基糖苷类和替加环素,在一家中国医院。
■从中国医院的9名患者中收集了一组10株CRKP菌株。抗微生物敏感性测试(AST)和表型抑制测定精确评估细菌抗生素抗性。实时定量PCR（RT-qPCR）用于分析外排泵基因（acrA/acrB和oqxA/oqxB）和调节基因（ramA）的mRNA水平。分析核心基因组树和PFGE模式以评估菌株的克隆和水平转移扩增。对名为Kpn20的肺炎克雷伯菌临床分离株进行全基因组测序，以鉴定关键耐药基因和抗微生物耐药岛（ARI）。
■CRKP菌株对碳青霉烯类有很高的抗性，氨基糖苷类（CLSI，2024),和替加环素（EUCAST，2024).RT-qPCR检测外排泵基因和调控基因的mRNA表达水平。所有10个分离株与ATCC13883的对照组相比具有显著差异。核心基因组树和PFGE模式揭示了五个簇，表明克隆和水平转移扩增。三个关键的抗性基因（blaoxa-232，blaCTX-M-15，和rmtF）在肺炎克雷伯菌临床分离株Kpn20中观察到。确定了含有blaCTX-M-15和rmtF的移动抗生素抗性岛，存在多个插入序列和转座子。报道了在高风险肺炎克雷伯菌菌株中blaoxa-232和rmtF共存。缀合测定用于水平研究blaoxa-232编码质粒的可转移性。
■该研究强调了具有多药耐药性的ST15-KL112高风险CRKP菌株的出现，包括氨基糖苷类和替加环素。移动ARI的存在以及菌株的克隆和水平转移扩增表明这些菌株的传播威胁。需要进一步的研究来评估此类分离株的患病率并制定有效的控制措施。
■从中国医院的9名患者中收集了一组10株CRKP菌株。抗微生物敏感性测试(AST)和表型抑制测定精确评估细菌抗生素抗性。实时定量PCR（RT-qPCR）用于分析外排泵基因（acrA/acrB和oqxA/oqxB）和调节基因（ramA）的mRNA水平。分析核心基因组树和PFGE模式以评估菌株的克隆和水平转移扩增。对名为Kpn20的肺炎克雷伯菌临床分离株进行全基因组测序，以鉴定关键耐药基因和抗微生物耐药岛（ARI）。
■CRKP菌株对碳青霉烯类有很高的抗性，氨基糖苷类（CLSI，2024),和替加环素（EUCAST，2024).RT-qPCR检测外排泵基因和调控基因的mRNA表达水平。所有10个分离株与ATCC13883的对照组相比具有显著差异。核心基因组树和PFGE模式揭示了五个簇，表明克隆和水平转移扩增。三个关键的抗性基因（blaoxa-232，blaCTX-M-15，和rmtF）在肺炎克雷伯菌临床分离株Kpn20中观察到。确定了含有blaCTX-M-15和rmtF的移动抗生素抗性岛，存在多个插入序列和转座子。报道了在高风险肺炎克雷伯菌菌株中blaoxa-232和rmtF共存。缀合测定用于水平研究blaoxa-232编码质粒的可转移性。
■该研究强调了具有多药耐药性的ST15-KL112高风险CRKP菌株的出现，包括氨基糖苷类和替加环素。移动ARI的存在以及菌株的克隆和水平转移扩增表明这些菌株的传播威胁。需要进一步的研究来评估此类分离株的患病率并制定有效的控制措施。
