The spread of CTX-M-type extended-spectrum beta-lactamases in China: Epidemiology and evolutionary analyses

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-03-03 DOI:10.1016/j.jinf.2025.106457

Keyi Yu , Zhenzhou Huang , Xiao Liu , He Gao , Xuemei Bai , Zhiwen Sun , Duochun Wang

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引用次数: 0

Abstract

CTX-M-type extended-spectrum beta-lactamases (ESBLs) have shown a high level of global transmission, with limited systematic understanding of their epidemic patterns in China. A comprehensive analysis covering 1974–2023 identified 133 (3.2%) bla_CTX-Ms-producing strains among 4146 strains from 25 Chinese cities across 82 genera were performed. Integrating with public database strains (n=431), the study comprised 564 bla_CTX-Ms-positive isolates sourced from 19 provinces (1986–2022) including 300 (53.2%) clinical and 228 (40.4%) environmental bla_CTX-Ms. The most frequent sources of infection were diarrhea (44%), upper respiratory tract infection (22.2%) and urinary tract infection (14%). Phylogenetic studies indicated CTX-M-1 and CTX-M-9 emerged as the predominant subgroups. Lineages exhibited diverse mutation sites without being restricted by geographical conditions. Ka/Ks ratio distribution varied significantly among lineages (P<0.05). Lineages 1 (L1) and L2 were characterized by neutral or purifying selection, whereas L3 was mainly under purifying selection. Adaptive evolution was noted at different loci within each lineage. The influence of geographic distance on phylogeny varied distinctly across different lineages. Notably, for Lineage L3, there was a remarkably strong correlation observed, which implies that human activities exerted a more substantial influence on genetic distances compared to geography. This research provides valuable insights into the epidemiology, genotypic diversity, and evolutionary traits of bla_CTX-Ms in China, supporting health risk assessment for early warning systems.

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ctx - m型广谱β -内酰胺酶在中国的传播：流行病学和进化分析

ctx - m型广谱β -内酰胺酶（ESBLs）已显示出高水平的全球传播，但对其在中国的流行模式系统了解有限。对1974-2023年中国25个城市4146株82属产blactx - ms菌株进行综合分析，鉴定出产blactx - ms菌株133株（3.2%）。结合公共数据库菌株（n=431），该研究包括来自19个省份（1986-2022年）的564株blaCTX-Ms阳性分离株，其中临床blaCTX-Ms 300株（53.2%），环境blaCTX-Ms 228株（40.4%）。最常见的感染源为腹泻（44%）、上呼吸道感染（22.2%）和尿路感染（14%）。系统发育研究表明CTX-M-1和CTX-M-9是主要亚群。谱系表现出不同的突变位点，不受地理条件的限制。Ka/Ks比值在不同世系间分布差异显著（p < 0.05）。谱系1 （L1）和L2以中性选择和纯化选择为主，而L3以纯化选择为主。适应性进化在每个谱系的不同位点被注意到。地理距离对系统发育的影响在不同世系间差异明显。值得注意的是，对于谱系L3，观察到非常强的相关性，这意味着与地理位置相比，人类活动对遗传距离的影响更大。该研究为了解中国blaCTX-Ms的流行病学、基因型多样性和进化特征提供了有价值的见解，为早期预警系统的健康风险评估提供了支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.