法国一家医院爆发的耐利奈唑胺表皮葡萄球菌疫情调查：表型、基因型和临床特征描述

IF 4 2区生物学 Q2 MICROBIOLOGY

Frontiers in Microbiology Pub Date : 2024-09-11 DOI:10.3389/fmicb.2024.1455945

Nadège Lépine, José Bras-Cachinho, Eva Couratin, Coralie Lemaire, Laura Chaufour, Armelle Junchat, Marie-Frédérique Lartigue

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引用次数: 0

摘要

目的我们旨在回顾性调查2017年至2021年间图尔大学医院爆发的耐利奈唑胺表皮葡萄球菌（LRSE）疫情。方法研究纳入了34株LRSE分离株中的20株。采用磁盘扩散法进行抗菌药敏感性检测，使用肉汤微量稀释法或 Etest® 测定最后一种抗生素的 MIC 值。20 株耐药菌株中有 17 株被送往法国国家葡萄球菌参考资料中心，以确定对利奈唑胺的耐药机制。通过 PFGE 评估了 LRSE 菌株之间的克隆关系，并通过 MLST 确定了序列类型。我们对新的分型工具 IR-Biotyper® 进行了回顾性评估，并将其结果与 PFGE 进行了比较，以评估其与表皮葡萄球菌分型的相关性。对病历进行了审查，并确定了抗生素的使用情况。结果所有 LRSE 菌株对利奈唑胺（MIC ≥ 256 mg/L）均表现出高度耐药性，并且具有多重耐药性。利奈唑胺耐药性与 23S rRNA G2576T 突变有关，分析的 17 株菌株中没有一株携带 cfr 基因。在所研究的 20 株 LRSE 菌株中，95% 的菌株具有遗传相关性，属于序列类型 ST2。从 IR-Biotyper® 中获得的树枝图与 PFGE 分析结果显示出 87% 的一致性。在分离出 LRSE 菌株之前，70% 的患者接受了利奈唑胺治疗。结论利奈唑胺可能会促进 LRSE 菌株的存活和传播。在图尔大学医院，耐药克隆的获得也可能是由医护人员的手对手传播引起的。此外，IR-Biotyper®成本低、周转时间短，是研究克隆爆发的一种很有前途的分型工具，但常规使用的最佳分析参数还需进一步研究评估。

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Investigation of a linezolid-resistant Staphylococcus epidermidis outbreak in a French hospital: phenotypic, genotypic, and clinical characterization

PurposeWe aimed to retrospectively investigate an outbreak of linezolid-resistant Staphylococcus epidermidis (LRSE), at Tours University Hospital between 2017 and 2021.MethodsTwenty of the 34 LRSE isolates were included in the study. Antimicrobial susceptibility testing was performed using the disk diffusion method and MICs of last-resort antibiotics were determined using broth microdilution or Etest®. Seventeen of the 20 resistant strains were sent to the French National Reference Centre for Staphylococci to determine the mechanism of resistance to linezolid. The clonal relationship between LRSE strains was assessed by PFGE and the sequence type determined by MLST. We retrospectively evaluated a new typing tool, IR-Biotyper®, and compared its results to PFGE to evaluate its relevance for S. epidermidis typing. Medical records were reviewed, and antibiotic consumption was determined. Search for a cross transmission was performed.ResultsAll LRSE strains showed high levels of resistance to linezolid (MICs ≥ 256 mg/L) and were multi-drug resistant. Linezolid resistance was associated with the 23S rRNA G2576T mutation and none of the 17 strains analyzed carried the cfr gene. Ninety-five percent of the 20 LRSE studied strains were genetically related and belonged to sequence-type ST2. The dendrogram obtained from IR-Biotyper® showed 87% congruence with the PFGE analysis. Prior to isolation of the LRSE strain, 70% of patients received linezolid. No patients stayed successively in the same room.ConclusionLinezolid exposure may promote the survival and spread of LRSE strains. At Tours University Hospital, acquisition of the resistant clone may also have been triggered by hand-to-hand transmission by healthcare workers. In addition, IR-Biotyper® is a promising typing tool for the study of clonal outbreaks due to its low cost and short turnaround time, although further studies are needed to assess the optimal analytical parameters for routine use.

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来源期刊

Frontiers in Microbiology MICROBIOLOGY-

CiteScore

7.70

自引率

9.60%

发文量

4837

审稿时长

14 weeks

期刊介绍： Frontiers in Microbiology is a leading journal in its field, publishing rigorously peer-reviewed research across the entire spectrum of microbiology. Field Chief Editor Martin G. Klotz at Washington State University is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.