基因组学方法揭示新生儿重症监护病房（NICU）表皮葡萄球菌分子流行病学的复杂性。

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-04-25 DOI:10.1016/j.jhin.2025.04.011

R.F. Rampelotto , N.A. Faria , R. Hörner , M. Miragaia

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引用次数: 0

摘要

表皮葡萄球菌引起的血液感染是新生儿重症监护病房（NICU）中最常见和最严重的感染之一，是造成高发病率和死亡率的原因。然而，表皮葡萄球菌是如何在新生儿重症监护室流行、传播和演变并导致疫情的，目前尚不清楚。我们旨在了解表皮葡萄球菌在新生儿重症监护室暴发的基因组基础，为更好地控制感染提供指导。我们收集了巴西一家医院NICU住院一年以上新生儿血液培养中分离的所有表皮葡萄球菌，并比较了它们的基因组。表皮葡萄球菌感染发生率为1.17例/婴儿年。83.64%的表皮葡萄球菌耐甲氧西林（MRSE）， 84.5%为序列2型（ST2）或相关，携带葡萄球菌盒式染色体mec (SCCmec) III型或IVa型。单核苷酸多态性（snp）分析表明，表皮葡萄球菌感染是由来自不同地方性来源的三条ST2传播链共存造成的(

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The complexity of Staphylococcus epidermidis molecular epidemiology in neonatal intensive care units (NICU) as revealed by genomic approaches

Bloodstream infections caused by Staphylococcus epidermidis are among the most frequent and serious infections in neonatal intensive care units (NICU), being responsible for high rates of morbidity and mortality. However, how S. epidermidis prevails, disseminates and evolves to cause outbreaks in NICU is poorly understood. We aimed to understand what is the genomic basis of S. epidermidis outbreaks in NICU to provide guidelines for a better infection control.

We collected all S. epidermidis isolated from newborn blood cultures admitted to a hospital NICU in Brazil over one-year and compared their genomes.

The S. epidermidis infection incidence rate was 1.17 per baby-year. 83,64% of S. epidermidis were resistant to methicillin (MRSE) and 84,5% belonged to sequence type 2 (ST2) or related, carrying the staphylococcal cassette chromosome mec (SCCmec) type III or IVa. Single nucleotide polymorphisms (SNPs) analysis showed that S. epidermidis infections resulted from the co-existence of three ST2 transmission chains originating from distinct endemic sources (<50 SNPs). Each transmission chain was characterized by specific antibiotic resistance and virulence profile and content in staphylococcal cassette chromosome elements (SCCmec, SCC non-mec and ACME). During transmission, other mobile genetic elements were acquired/lost and mutations emerged in genes involved in adhesion, signal transduction, general metabolism, replication, recombination and repair.

Tracking S. epidermidis transmission chains in the NICU will require a deep genomic analysis, combining bacterial genetic background and accessory genome. This study highlighted the need for the integration of whole genome sequencing as a key surveillance tool for infection control in NICUs.

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.