尿液分离出的泄殖腔肠杆菌中整合子的分布特征及抗生素耐药性的相关性分析

IF 4.6 2区 医学 Q2 IMMUNOLOGY
Frontiers in Cellular and Infection Microbiology Pub Date : 2024-10-01 eCollection Date: 2024-01-01 DOI:10.3389/fcimb.2024.1462742
Xuedan Qiu, Hui Zhang, Min Jiang, Qiaoping Wu, Qingcao Li, Guangliang Wu
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引用次数: 0

摘要

研究目的本研究旨在了解我院临床尿液标本中分离出的阴沟肠杆菌中整合子的分布情况,以及整合子阳性菌株可变区耐药基因盒的分子特征及其与耐药性的关系:收集2019年8月至2023年7月期间我院住院患者尿液标本中分离出的80株阴沟肠杆菌,并对其进行药敏试验。采用聚合酶链式反应(PCR)技术对这些菌株的1、2、3类整合子进行筛选。随后,对整合子阳性菌株的启动子和可变区进行扩增和测序。此外,还利用肠杆菌重复基因间共识 PCR(ERIC-PCR)对整合素阳性菌株进行同源性分析:结果:在 80 株临床菌株中,31 株(38.8%)检测到 1 类整合子,并鉴定出以下抗性基因盒:aadA2、aadA1、aadB、aac(6') 和 catB8。观察到三种类型的可变区启动子:PcS(4 株)、PcW(7 株)和 PcH1(17 株),下游 P2 启动子始终处于非活性状态。此外,在 5 株(6.3%)菌株中检测到了第 2 类整合子,它们携带可变区抗性基因盒 dfrA1-sat2-aadA1。第 2 类整合子的启动子统一为 Pc2D-Pc2A-Pc2B-Pc2C 类型。没有检测到第 3 类整合子。与无整合子的菌株相比,含有整合子的菌株对环丙沙星、复方磺胺甲噁唑、左氧氟沙星、庆大霉素、阿米卡星和妥布霉素的耐药率明显更高(携带整合子的丁香杆菌主要分为三种基因型:A、B和C:这些基因型主要分布在泌尿科和重症监护室(ICU)。可变区基因框和启动子类型的分布在同一基因型中相对集中:我们的研究证实,从尿液样本中分离出的泄殖腔肠杆菌主要携带 1 类整合子,并具有一系列扩展的抗生素耐药基因。建议在今后的研究中探索更多的耐药机制,并评估新治疗策略的有效性。临床医生应警惕克隆传播的可能性,并在医院环境中加强感染控制措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distribution characteristics of integrons and correlation analysis of antibiotic resistance in urine isolated Enterobacter cloacae.

Objective: This study aims to understand the distribution of integrons among Enterobacter cloacae isolated from clinical urine specimens in our hospital, as well as the molecular characteristics of the variable region resistance gene cassette of integron-positive strains and its relationship with drug resistance.

Methods: We collected a total of 80 strains of Enterobacter cloacae isolated from urine specimens of hospitalized patients in our hospital between August 2019 and July 2023, and conducted drug sensitivity testing on them. Polymerase Chain Reaction (PCR) technology was employed to screen these strains for Class 1, 2, and 3 integrons. Following this, the promoter and variable regions of integron-positive strains were amplified and sequenced. Additionally, Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR) was utilized for homology analysis of integron-positive strains.

Results: Among the 80 clinical strains, Class 1 integrons were detected in 31 (38.8%) strains, and the following resistance gene cassettes were identified: aadA2, aadA1, aadB, aac(6'), and catB8. Three types of variable region promoters were observed: PcS (4 strains), PcW (7 strains), and PcH1 (17 strains), with consistently inactive downstream P2 promoters. Additionally, Class 2 integrons were detected in 5 (6.3%) strains, carrying the variable region resistance gene cassette dfrA1-sat2-aadA1. The promoters for Class 2 integrons were uniformly of the Pc2D-Pc2A-Pc2B-Pc2C type. No Class 3 integrons were detected. The strains containing integrons showed significantly higher resistance rates to ciprofloxacin, compound sulfamethoxazole, levofloxacin, gentamicin, amikacin, and tobramycin compared to those without integrons (P<0.05). 35 strains of Enterobacter cloacae carrying integrons are primarily classified into three genotypes: A, B, and C. These genotypes are mainly distributed in the urology department and Intensive Care Unit (ICU). The distribution of variable region gene boxes and promoter types is relatively concentrated in the same genotype.

Conclusion: Our study confirmed that Enterobacter cloacae isolated from urine samples predominantly carries Class 1 integrons with an extended array of antibiotic-resistant genes. For future research, it is recommended to explore additional resistance mechanisms and evaluate the effectiveness of new therapeutic strategies. Clinicians should be vigilant about the possibility of clonal dissemination and implement enhanced infection control measures in hospital settings.

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来源期刊
CiteScore
7.90
自引率
7.00%
发文量
1817
审稿时长
14 weeks
期刊介绍: Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. 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. Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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