中国广泛耐药高病毒铜绿假单胞菌分离株的分子特征。

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Jun Li, Mengli Tang, Zhaojun Liu, Yuhan Wei, Fengjun Xia, Yubing Xia, Yongmei Hu, Haichen Wang, Mingxiang Zou
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引用次数: 0

摘要

背景:最近,越来越多的铜绿假单胞菌(XDR-PA)分离物被发现,这给临床抗感染治疗带来了巨大挑战。然而,人们对广泛耐药的高病毒铜绿假单胞菌(XDR-hvPA)知之甚少。本研究调查了其流行病学特征,为防止其传播提供了重要依据:收集了2018年1月至2023年1月期间的临床XDR-PA分离株,并使用基质辅助激光解吸/电离飞行时间质谱进行了鉴定;采用肉汤微稀释法进行了抗生素药敏试验,并评估了最低抑菌浓度(MIC)。病毒的致病力是通过黑线蝇(Galleria mellonella)感染模型进行评估的;分子特征,包括抗性基因、致病力基因和同源性,是通过全基因组测序确定的:结果:共收集到 77 株 XDR-PA 菌株,其中 47/77 株为 XDR-hvPA 菌株。年龄大于 60 岁的患者中,XDR-hvPA 的检出率明显高于 XDR-non-hvPA。在 47 株 XDR-hvPA 菌株中,有 24 株携带碳青霉烯酶基因,包括 blaGES-1 (10/47)、blaVIM-2 (6/47)、blaGES-14 (4/47)、blaIMP-45 (2/47)、blaKPC-2 (1/47) 和 blaNDM-14 (1/47)。在 31/47、47/47、46/47 和 29/47 株中分别发现了 PA 的重要毒力因子 exoU、exoT、exoY 和 exoS。值得注意的是,两株 XDR-hvPA 同时携带 exoU 和 exoS。检测到六种血清型(O1、O4-O7 和 O11);O11(19/47)、O7(13/47)和 O4(9/47)最为普遍。2018-2020 年,O4 和 O7 是最流行的血清型;2021 年以后,O11(16/26)是最流行的血清型。检测到的 ST 类型有 14 种,主要是 ST235(14/47)、ST1158(13/47)和 ST1800(7/47)。5例全球流行的ST235 XDR-hvPA携带blaGES,头孢他啶/阿维菌素的MIC值达到敏感性断点(8/4 mg/L):结论:XDR-hvPA的临床检出率出乎意料地高,尤其是年龄大于60岁的患者,他们似乎更容易感染这种疾病。携带 blaGES(属于全球流行病 ST235)的 XDR-hvPA 存在克隆传播。因此,应加强对 XDR-hvPA 的监测,尤其是对老年住院患者,以防止其传播。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Molecular characterization of extensively drug-resistant hypervirulent Pseudomonas aeruginosa isolates in China.

Background: Recently, extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) isolates have been increasingly detected and posed great challenges to clinical anti-infection treatments. However, little is known about extensively resistant hypervirulent P. aeruginosa (XDR-hvPA). In this study, we investigate its epidemiological characteristics and provide important basis for preventing its dissemination.

Methods: Clinical XDR-PA isolates were collected from January 2018 to January 2023 and identified using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry; antibiotic susceptibility testing was performed by broth microdilution method, and minimum inhibitory concentrations (MICs) were evaluated. Virulence was evaluated using the Galleria mellonella infection model; molecular characteristics, including resistance genes, virulence genes, and homology, were determined using whole-genome sequencing.

Results: A total of 77 XDR-PA strains were collected; 47/77 strains were XDR-hvPA. Patients aged > 60 years showed a significantly higher detection rate of XDR-hvPA than of XDR-non-hvPA. Among the 47 XDR-hvPA strains, 24 strains carried a carbapenemase gene, including blaGES-1 (10/47), blaVIM-2 (6/47), blaGES-14 (4/47), blaIMP-45 (2/47), blaKPC-2 (1/47), and blaNDM-14 (1/47). ExoU, exoT, exoY, and exoS, important virulence factors of PA, were found in 31/47, 47/47, 46/47, and 29/47 strains, respectively. Notably, two XDR-hvPA simultaneously co-carried exoU and exoS. Six serotypes (O1, O4-O7, and O11) were detected; O11 (19/47), O7 (13/47), and O4 (9/47) were the most prevalent. In 2018-2020, O4 and O7 were the most prevalent serotypes; 2021 onward, O11 (16/26) was the most prevalent serotype. Fourteen types of ST were detected, mainly ST235 (14/47), ST1158 (13/47), and ST1800 (7/47). Five global epidemic ST235 XDR-hvPA carried blaGES and showed the MIC value of ceftazidime/avibactam reached the susceptibility breakpoint (8/4 mg/L).

Conclusions: The clinical detection rate of XDR-hvPA is unexpectedly high, particularly in patients aged > 60 years, who are seemingly more susceptible to contracting this infection. Clonal transmission of XDR-hvPA carrying blaGES, which belongs to the global epidemic ST235, was noted. Therefore, the monitoring of XDR-hvPA should be strengthened, particularly for elderly hospitalized patients, to prevent its spread.

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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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