Multiplex PCR Analysis for Rapid Detection of Klebsiella pneumoniae Carbapenem-Resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains
机构：[a]Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China[b]Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China[c]Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China[d]Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China[e]Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA[f]Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada[g]Case VA Center for Antimicrobial Resistance and Epidemiology (CARES), Cleveland, Ohio, USA[h]Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA[i]Department of Medicine, Pharmacology, Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio, USA[j]Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA[k]Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, New York, USA[l]Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada[m]Department of Pharmacology, Case Western Reserve University, Cleveland, Ohio, USA[n]Department of Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio, USA
Carbapenem-resistant and hypervirulent Klebsiella pneumoniae strains have emerged recently. These strains are both hypervirulent and multidrug resistant and may also be highly transmissible and able to cause severe infections in both the hospital and the community. Clinical and public health needs require a rapid and comprehensive molecular detection assay to identify and track the spread of these strains and provide timely infection control information. Here, we develop a rapid multiplex PCR assay capable of distinguishing K. pneumoniae carbapenem-resistant isolates of sequence type 258 (ST258) and 5T11, and hypervirulent ST23, ST65/ST375, and ST86 clones, as well as capsular types K1, K2, K locus type 47 (KL47), and KL64, and virulence genes rmpA, rmpA2, iutA, and iroN. The assay demonstrated 100% concordance with 118 previously genotyped K. pneumoniae isolates and revealed different populations of carbapenem-resistant and hypervirulent strains in two collections in China and the United States. The results showed that carbapenem-resistant and hypervirulent K. pneumoniae strains are still rare in the United States, whereas in China, similar to 50% of carbapenem-resistant strains carry rmpA/rmpA2 and iutA virulence genes, which are largely associated with the epidemic 5T11 strains. Similarly, a high prevalence of hypervirulent strains was found in carbapenem-susceptible isolates in two Chinese hospitals, but these primarily belong to ST23, ST65/ST375, and ST86, which are distinct from the carbapenem-resistant strains. Taken together, our results demonstrated that this PCR assay can be a useful tool for molecular surveillance of carbapenem-resistant and hypervirulent K. pneumoniae strains.
基金：
This work was in part supported by the following grants from the National Institutes
of Health (R01AI090155, R21AI135250, R21AI117338, and CA008748), and by the Key
Research and Development project of Jiangsu Provincial Science and Technology
Department (BE2017654), Six Talent Peaks Project in Jiangsu Province (2016-WSN-112),
Gusu Key Health Talent of Suzhou, Jiangsu Youth Medical Talents Program (QN-867) and the Science and Technology Program of Suzhou (SZS201715). In addition, research
reported in this publication was also supported in part by the National Institute of
Allergy and Infectious Diseases of the National Institutes of Health under Award
Numbers R21AI114508 (R.A.B.), R01AI100560 (R.A.B.), R01AI063517 (R.A.B.), and
R01AI072219 (R.A.B.).
第一作者机构：[a]Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China[b]Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
共同第一作者：
通讯作者：
通讯机构：[j]Public Health Research Institute Tuberculosis Center, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA
推荐引用方式(GB/T 7714)：
Fangyou Yu ,Jingnan Lv ,Siqiang Niu ,et al.Multiplex PCR Analysis for Rapid Detection of Klebsiella pneumoniae Carbapenem-Resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains[J].JOURNAL OF CLINICAL MICROBIOLOGY.2018,56(9):doi:10.1128/JCM.00731-18.
APA：
Fangyou Yu,,Jingnan Lv,,Siqiang Niu,,Hong Du,,Yi-Wei Tang,...&Liang Chen.(2018).Multiplex PCR Analysis for Rapid Detection of Klebsiella pneumoniae Carbapenem-Resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains.JOURNAL OF CLINICAL MICROBIOLOGY,56,(9)
MLA：
Fangyou Yu,,et al."Multiplex PCR Analysis for Rapid Detection of Klebsiella pneumoniae Carbapenem-Resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains".JOURNAL OF CLINICAL MICROBIOLOGY 56..9(2018)
医学