ICU患者Tn2006转座子中携带blaOXA-23基因的耐碳青霉烯鲍曼不动杆菌的宏基因组和全基因组特征

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance Pub Date : 2025-06-22 DOI:10.1016/j.jgar.2025.06.009

Senhong Ying , Zhirong Zhang , Rong Xiang

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Antimicrobial susceptibility testing and comparative genomic analysis were performed.</div></div><div><h3>Results</h3><div>Metagenomic next-generation sequencing revealed mixed infections in 71.4% of patients, identifying multiple bacteria, viruses, fungi, and <em>Mycoplasma</em> species. <em>A. baumannii</em> was detected in 25 samples, often alongside other pathogens. All isolates harboured <em>bla</em><sub>OXA-23</sub> within Tn<em>2006</em> on the chromosome and belonged to sequence type ST2, indicating clonal dissemination despite significant genetic diversity (up to 2969 single-nucleotide polymorphism differences). The isolates were highly resistant to multiple antibiotics but remained susceptible to tigecycline and colistin. 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引用次数: 0

摘要

目的：利用元基因组和全基因组测序技术对Tn2006转座子中携带blaxa -23基因的耐碳青霉烯鲍曼不动杆菌进行鉴定，重点研究其遗传特征、耐药性以及在ICU患者中克隆传播和水平基因转移的可能性。方法：应用mNGS检测28例ICU患者支气管肺泡灌洗液的病原菌及耐药基因。鲍曼不动杆菌分离株采用全基因组测序进行遗传多样性评估。进行了药敏试验和比较基因组分析。结果：71.4%的患者在mNGS中发现混合感染，鉴定出多种细菌、病毒、真菌和支原体。在25个样本中检测到鲍曼不动杆菌，通常与其他病原体一起。所有分离株在Tn2006染色体上都含有blaOXA-23，属于ST2序列型，尽管存在显著的遗传多样性（高达2,969个SNP差异），但表明克隆传播。该菌株对多种抗生素均有高度耐药，但对替加环素和粘菌素敏感。与全球238个螃蟹基因组的比较基因组分析证实，携带blaOXA-23的Tn2006转座子在ST2菌株中普遍存在，强调了这种耐药机制快速传播的可能性。结论：在ICU患者中广泛存在携带blaOXA-23的耐多药鲍曼不动杆菌，引起了重大的公共卫生问题。混合感染的高发生率和潜在的水平基因转移使危重患者的感染管理复杂化。迫切需要加强感染控制措施、持续监测和有针对性的干预措施，以防止这些耐药菌株在医院环境中进一步传播。

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Metagenomic and whole-genome characterization of carbapenem-resistant Acinetobacter baumannii carrying blaOXA-23 gene within the Tn2006 transposon among ICU patients

Purpose

To characterize carbapenem-resistant Acinetobacter baumannii carrying bla_OXA-23 genes within the Tn2006 transposon using metagenomic and whole-genome sequencing, focusing on their genetic features, antimicrobial resistance, and potential for clonal spread and horizontal gene transfer among intensive care unit (ICU) patients.

Methods

Bronchoalveolar lavage fluid samples from 28 ICU patients were analysed using metagenomic next-generation sequencing to detect pathogens and resistance genes. A. baumannii isolates underwent whole-genome sequencing for genetic diversity assessment. Antimicrobial susceptibility testing and comparative genomic analysis were performed.

Results

Metagenomic next-generation sequencing revealed mixed infections in 71.4% of patients, identifying multiple bacteria, viruses, fungi, and Mycoplasma species. A. baumannii was detected in 25 samples, often alongside other pathogens. All isolates harboured bla_OXA-23 within Tn2006 on the chromosome and belonged to sequence type ST2, indicating clonal dissemination despite significant genetic diversity (up to 2969 single-nucleotide polymorphism differences). The isolates were highly resistant to multiple antibiotics but remained susceptible to tigecycline and colistin. Comparative genomic analysis with 238 global carbapenem-resistant A. baumannii genomes confirmed the prevalence of the Tn2006 transposon carrying bla_OXA-23 in ST2 strains, emphasizing the potential for rapid spread of this resistance mechanism.

Conclusions

The widespread presence of multidrug-resistant A. baumannii carrying bla_OXA-23 within Tn2006 among ICU patients poses a significant public health concern. The high rate of mixed infections and the potential for horizontal gene transfer complicate infection management in critically ill patients. Enhanced infection control measures, continuous surveillance, and targeted interventions are urgently needed to prevent further dissemination of these resistant strains in hospital settings.

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来源期刊

Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

8.70

自引率

2.20%

发文量

285

审稿时长

34 weeks

期刊介绍： The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.