Emergence of Klebsiella pneumoniae carbapenemase-producing Proteus mirabilis in Hangzhou, China  

作　　者：SHENG Zi-ke LI Jun-jie SHENG Guo-ping SHENG Ji-fang LI Lan-juan 

机构地区：[1]Department of Infectious Disease, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China

出　　处：《Chinese Medical Journal》2010年第18期2568-2570,共3页中华医学杂志（英文版）

摘　　要：Background Carbapenems are used to treat severe infections caused by multi-drug-resistant organisms, however, the emergence of carbapenem-resistant bacterial isolates is becoming an increasing therapeutic challenge. Since the first Klebsiella （K.） pneumoniae carbapenemase （KPC）-producing K. pneumoniae was reported in 2001, KPC-producing isolates have been found increasingly, specially in Enterobacteriaceae. The aim of this study was to characterize the mechanisms of a carbapenem-resistant Proteus （P.） mirabilis. Methods A carbapenem-resistant P. mirabilis isolate was recovered from pleural drainage fluid of a patient admitted to surgical intensive care unit. Antimicrobial susceptibility testing of the isolate was performed by disk diffusion according to Clinical and Laboratory Standards Institute guidelines, and subsequent minimal inhibitory concentrations were determined with the E-test. Amplification of the blaKPC gene generated a positive band and the PCR products were sequenced subsequently. The plasmid of the isolate was extracted and was successfully transformed into Escherichia （E.） coli DH5a. Results The P. mirabilis isolate was resistant to all detected antimicrobial agents except tigecycline. KPC-2 was confirmed by DNA sequence analysis. The transformant E. coil was resistant to carbapenems. Further study demonstrated that upstream and downstream regions of b/aKPC-2 were identical to that observed in K. pneumoniae submitted to GenBank from China in 2007. Conclusion Carbapenem resistance in the P. mirabilis isolate in this study is mainly due to production of KPC-2.Background Carbapenems are used to treat severe infections caused by multi-drug-resistant organisms, however, the emergence of carbapenem-resistant bacterial isolates is becoming an increasing therapeutic challenge. Since the first Klebsiella （K.） pneumoniae carbapenemase （KPC）-producing K. pneumoniae was reported in 2001, KPC-producing isolates have been found increasingly, specially in Enterobacteriaceae. The aim of this study was to characterize the mechanisms of a carbapenem-resistant Proteus （P.） mirabilis. Methods A carbapenem-resistant P. mirabilis isolate was recovered from pleural drainage fluid of a patient admitted to surgical intensive care unit. Antimicrobial susceptibility testing of the isolate was performed by disk diffusion according to Clinical and Laboratory Standards Institute guidelines, and subsequent minimal inhibitory concentrations were determined with the E-test. Amplification of the blaKPC gene generated a positive band and the PCR products were sequenced subsequently. The plasmid of the isolate was extracted and was successfully transformed into Escherichia （E.） coli DH5a. Results The P. mirabilis isolate was resistant to all detected antimicrobial agents except tigecycline. KPC-2 was confirmed by DNA sequence analysis. The transformant E. coil was resistant to carbapenems. Further study demonstrated that upstream and downstream regions of b/aKPC-2 were identical to that observed in K. pneumoniae submitted to GenBank from China in 2007. Conclusion Carbapenem resistance in the P. mirabilis isolate in this study is mainly due to production of KPC-2.

关 键 词：ENTEROBACTERIACEAE proteus mirabilis carbapenem Klebsiella pneumoniae carbapenemase 

分 类 号：Q556[生物学—生物化学] S858.93[农业科学—临床兽医学]