背景:关键优先耐碳青霉烯类高毒力肺炎克雷伯菌(CR-hvKp)通过食物来源的全球传播代表了重大的公共卫生问题。埃及牡蛎中CR-hvKp的流行病学数据有限。这项研究旨在调查在埃及出售的牡蛎作为耐碳青霉烯类肺炎克雷伯菌(CRKP)来源的潜在作用。高毒力肺炎克雷伯菌(hvKp),和CR-hvKp,并评估相关的人畜共患风险。
方法:从埃及的各个零售鱼市场随机购买了330个新鲜牡蛎样品,并将其分为33个池。对肺炎克雷伯菌进行细菌学检查和鉴定。通过表型和分子方法确定肺炎克雷伯菌分离株的碳青霉烯耐药性。此外,基于毒力基因标记(peg-344,rmpA,rmpA2,iucA,和iroB),后跟字符串测试。使用带有pheatmap包的R进行CR-hvKp菌株的聚类。
结果:肺炎克雷伯菌的总体患病率为48.5%(33人中有16人),有13个分离株显示碳青霉烯耐药性,一个中间阻力,两个敏感。耐碳青霉烯类肺炎克雷伯菌和耐碳青霉烯类肺炎克雷伯菌菌株均表现出碳青霉烯酶的产生,主要与blaVIM基因相关(68.8%)。HvKp菌株的鉴定率为62.5%(10/16);值得注意的是,peg-344是最普遍的基因。重要的是,13个CRKP分离株中有10个具有高毒力基因,有助于CR-hvKp的出现。此外,聚类分析显示,来自同一零售鱼市场的两个CR-hvKp分离株聚集。
结论:这项研究首次揭示了埃及牡蛎中CR-hvKp的出现。它强调了牡蛎作为在水生生态系统中传播CR-hvKp的来源的潜在作用,可能对公众健康造成威胁。
BACKGROUND: The global dissemination of critical-priority carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) via food sources represents a significant public health concern. Epidemiological data on CR-hvKp in oysters in Egypt is limited. This study aimed to investigate the potential role of oysters sold in Egypt as a source for carbapenem-resistant K. pneumoniae (CRKP), hypervirulent K. pneumoniae (hvKp), and CR-hvKp and assess associated zoonotic risks.
METHODS: A sample of 330 fresh oysters was randomly purchased from various retail fish markets in Egypt and divided into 33 pools. Bacteriological examination and the identification of Klebsiella pneumoniae were performed. Carbapenem resistance in K. pneumoniae isolates was determined by phenotypic and molecular methods. Additionally, the presence of hypervirulent K. pneumoniae was identified based on virulence gene markers (peg-344, rmpA, rmpA2, iucA, and iroB), followed by a string test. The clustering of CR-hvKp strains was carried out using R with the pheatmap package.
RESULTS: The overall prevalence of K. pneumoniae was 48.5% (16 out of 33), with 13 isolates displaying carbapenem resistance, one intermediate resistance, and two sensitive. Both carbapenem-resistant K. pneumoniae and carbapenem-intermediate-resistant K. pneumoniae strains exhibited carbapenemase production, predominantly linked to the blaVIM gene (68.8%). HvKp strains were identified at a rate of 62.5% (10/16); notably, peg-344 was the most prevalent gene. Significantly, 10 of the 13 CRKP isolates possessed hypervirulence genes, contributing to the emergence of CR-hvKp. Moreover, cluster analysis revealed the clustering of two CR-hvKp isolates from the same retail fish market.
CONCLUSIONS: This study provides the first insight into the emergence of CR-hvKp among oysters in Egypt. It underscores the potential role of oysters as a source for disseminating CR-hvKp within aquatic ecosystems, presenting a possible threat to public health.