Elucidation of carbapenem-resistant Klebsiella pneumoniae emerging mechanisms to prevent the infection
| Project/Area Number |
17K10027
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Infectious disease medicine
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| Research Institution | Nara Medical University |
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Principal Investigator |
Nakano Ryuichi 奈良県立医科大学, 医学部, 准教授 (80433712)
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| Co-Investigator(Kenkyū-buntansha) |
矢野 寿一 奈良県立医科大学, 医学部, 教授 (20374944)
遠藤 史郎 国際医療福祉大学, 国際医療福祉大学塩谷病院, 教授 (40614491)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | カルバペネム耐性腸内細菌科（CRE） / カルバペネマーゼ産生腸内細菌科（CPE） / ゲノム型 / プラスミド型 / 病原因子 / 検出法 / ディスク法 / LAMP法 / カルバペネム耐性肺炎桿菌 / カルバペネマーゼ / ポーリン欠損 / NmcA産生菌 / カルバペネマーゼ非産生CRE / 腸内細菌科 / NMC-A / 薬剤耐性菌 / 肺炎桿菌 |
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| Outline of Final Research Achievements |
In this study, we characterized clinical isolates of carbapenem-resistant Enterobacteriaceae (CRE) in Japan, in terms of their carbapenem resistance mechanisms, genotypes, plasmid types, and virulence determinants. Molecular analysis indicated that carbapenemase-producing Klebsiella pneumoniae were harboring IMP type carbapenemase. Mechanisms of non-carbapenemase-producing-CRE was production of ESBLs or AmpC in combination with porin loss/deficiency. Our results also show that highly virulent carbapenemase-producing K. pneumoniae clinical isolates are emerging in Japan.
Furthermore, we have developed a loop-mediated isothermal amplification (LAMP) method and double-disk synergy test for detection of NmcA carbapenemase producing Enterobacteriaceae with high specificity and sensitivity. It may be routinely applied for detection of carbapenemase producers in the clinical laboratory.
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| Academic Significance and Societal Importance of the Research Achievements |
本邦の医療機関で分離されるCREについて、海外とは異なる独特な特徴が明らかになった。IMP型カルバペネマーゼが優性であり、遺伝学的特徴からプラスミドに共通性があった。プラスミドの伝達性も高い事から菌種を越えた拡がりの可能性も考えられた。また病原性肺炎桿菌が多く含まれていたことからも、臨床現場においてこの耐性株の拡がりについては注視していく必要があるだろう。
臨床現場での応用を想定したCREの検出法も開発した。感度・特異度ともに高いため、迅速検出や診断に貢献することが期待される。
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Report
(4 results)
Research Products
(41 results)
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[Journal Article] Environmental presence and genetic characteristics of carbapenemase-producing Enterobacteriaceae from hospital sewage and river water in the Philippines.2020
Author(s)
Suzuki Y, Nazareno PJ, Nakano R, Mondoy M, Nakano A, Bugayong MP, Bilar J, Perez M 5th, Medina EJ, Saito-Obata M, Saito M, Nakashima K, Oshitani H, Yano H
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Journal Title
Appl Environ Microbiol
Volume: 88
Issue: 2
DOI
Related Report
Peer Reviewed / Open Access / Int'l Joint Research
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[Journal Article] Comparison between IMP carbapenemase-producing Enterobacteriaceae and non-carbapenemase-producing Enterobacteriaceae: a multicentre prospective study of the clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae.2020
Author(s)
Hayakawa K, Nakano R, Hase R, Shimatani M, Kato H, Hasumi J, Doi A, Sekiya N, Nei T, Okinaka K, Kasahara K, Kurai H, Nagashima M, Miyoshi-Akiyama T, Kakuta R, Yano H, Ohmagari N.
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Journal Title
J Antimicrob Chemother.
Volume: 75
Issue: 3
Pages: 697-708
DOI
Related Report
Peer Reviewed
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[Journal Article] Comparison of the inoculum size effects in blaIMP-6 and plasmid-mediated quinolone resistance gene-positive Enterobacteriaceae in Japan.2019
Author(s)
Ogawa Y, Nakano R, Kasahara K, Mizuno T, Hirai N, NakanoA, Suzuki Y, Kakuta N, Masui T, Yano H, Mikasa K
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Journal Title
PLoS ONE
Volume: 14
Issue: 11
Pages: e0225210-e0225210
DOI
Related Report
Peer Reviewed / Open Access
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