Clonal spread of trimethoprim-sulfamethoxazole-resistant Stenotrophomonas maltophilia isolates in a tertiary hospital.

IF 1.7 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
GMS Hygiene and Infection Control Pub Date : 2024-05-17 eCollection Date: 2024-01-01 DOI:10.3205/dgkh000481
Ömür Mustafa Parkan, Hüseyin Kiliç, Emine Alp, Demet Timur, Aycan Gündoğdu, Özlem Ünaldi, Rıza Durmaz
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引用次数: 0

Abstract

Aim: The aims of this study were to: (i) determine antibiotic susceptibility of clinical Stenotrophomonas maltophilia isolates, (ii) investigate the presence of different classes of integrons and sul genes responsible for sulphonamide resistance, (iii) assess the molecular epidemiology of the isolates by determining their clonal relatedness, and (iv) investigate the potential sources of infection by collecting environmental samples when necessary.

Methods: 99 S. maltophilia isolates from clinical specimens of hospitalized patients were screened by PCR for sul1, sul2, sul3 genes, and integron-associated integrase genes: intI1, intI2, and intI3. PFGE was used to determine the clonal relatedness of the isolates.

Results: Susceptibility rates for trimethoprim-sulfamethoxazole, levofloxacin, and ceftazidime were 90.9%, 91.9%, and 53.5% respectively. All trimethoprim-sulfamethoxazole-resistant isolates were positive for intI1 and sul1. PFGE analysis revealed that 24 of the isolates were clonally related, clustering in seven different clones. Five of the nine trimethoprim-sulfamethoxazole-resistant isolates were clonally related. The first isolate in this clone was from a wound sample of a patient in the infectious diseases clinic, and the other four were isolated from the bronchoalveolar lavage samples of patients in the thoracic surgery unit. The patient with the first isolate neither underwent bronchoscopy nor stayed in the thoracic surgery unit. Although clustering was observed in bronchoalveolar lavage samples, no S. maltophilia growth was detected in environmental samples.

Conclusion: The findings demonstrated that the sul1 gene carried by class 1 integrons plays an important role in trimethoprim-sulfamethoxazole resistance in S. maltophilia isolates. PFGE analysis revealed a high degree of genetic diversity. However, detection of clonally related isolates suggests the acquisition from a common source and/or cross-transmission of this microorganism between the patients.

一家三级医院中耐药三甲氧苄青霉素-磺胺甲噁唑的嗜麦芽汁霉单胞菌分离株的克隆传播。
目的:本研究旨在(i)确定临床嗜麦芽霉单胞菌分离株对抗生素的敏感性;(ii)调查导致磺胺类药物耐药性的不同类型的整合子和 sul 基因的存在情况;(iii)通过确定分离株的克隆相关性评估其分子流行病学;(iv)必要时通过采集环境样本调查潜在的感染源。方法:通过 PCR 检测 sul1、sul2、sul3 基因和整合相关的整合酶基因 intI1、intI2 和 intI3,筛选从住院病人临床标本中分离出的 99 株嗜麦芽糖酵母菌。使用 PFGE 测定分离株的克隆相关性:对三甲双胍-磺胺甲噁唑、左氧氟沙星和头孢他啶的敏感率分别为 90.9%、91.9% 和 53.5%。所有耐三甲氧苄青霉素-磺胺甲恶唑的分离株的 intI1 和 sul1 均呈阳性。PFGE 分析显示,其中 24 个分离株具有克隆关系,聚集在 7 个不同的克隆中。9 个耐三甲双胍-磺胺甲噁唑的分离株中有 5 个具有克隆关系。该克隆中的第一个分离株来自传染病诊所一名病人的伤口样本,其他四个分离株来自胸外科病人的支气管肺泡灌洗液样本。第一个分离株的患者既没有接受支气管镜检查,也没有在胸外科住院。虽然在支气管肺泡灌洗液样本中观察到了集群现象,但在环境样本中未检测到嗜麦芽汁酵母菌的生长:结论:研究结果表明,1 类整合子携带的 sul1 基因在嗜麦芽糖酵母菌分离株的三甲双胍-磺胺甲噁唑耐药性中起着重要作用。PFGE 分析显示了高度的遗传多样性。然而,检测到的克隆相关分离物表明,这种微生物是从一个共同的来源获得的和/或在患者之间交叉传播。
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来源期刊
GMS Hygiene and Infection Control
GMS Hygiene and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
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