2017年和2023年儿童腹泻中碳青霉烯类、替加环素类和多粘菌素耐药肠杆菌科的比较流行病学及耐药机制

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Antimicrobial Agents Pub Date : 2025-07-23 DOI:10.1016/j.ijantimicag.2025.107580

Jing Zhang , Hanyu Wang , Yingling Ni , Zelin Yan , Dan Chi , Kewei Li , Rong Zhang

{"title":"2017年和2023年儿童腹泻中碳青霉烯类、替加环素类和多粘菌素耐药肠杆菌科的比较流行病学及耐药机制","authors":"Jing Zhang , Hanyu Wang , Yingling Ni , Zelin Yan , Dan Chi , Kewei Li , Rong Zhang","doi":"10.1016/j.ijantimicag.2025.107580","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant <em>Enterobacteriaceae</em> isolated from pediatric diarrhoea cases in 2017 and 2023.</div></div><div><h3>Methods</h3><div>Fecal samples from children with diarrhoea were collected in Zhejiang, China, in 2017 and 2023. Bacterial isolation, antimicrobial susceptibility testing, and whole-genome sequencing were performed to identify resistance determinants and plasmid types.</div></div><div><h3>Results</h3><div>The prevalence of <em>mcr-1</em>-positive strains declined significantly from 2.36% (25/1059) in 2017 to 0.82% (3/367) in 2023, while <em>tet</em>(X4)-positive strains rose from 0% to 1.91% (7/367). Carbapenemase-producers remained rare (0.28% in 2017; 1.63% in 2023), with <em>bla</em><sub>NDM</sub> as the dominant carbapenemase gene. Whole genome sequencing revealed diverse antimicrobial resistance genes (ARGs) and evolving plasmid types. Notably, by 2023, all <em>mcr-1</em> were carried on IncI2 plasmids. Conjugation experiments confirmed plasmids carrying <em>mcr-1, bla</em><sub>NDM-5</sub>, and <em>tet</em>(X4) are transferable to a recipient strain.</div></div><div><h3>Conclusions</h3><div>The rising prevalence of multidrug-resistant Enterobacteriaceae in pediatric diarrhoea highlights the urgent need for continuous surveillance and effective infection control measures.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107580"},"PeriodicalIF":4.6000,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant Enterobacteriaceae in pediatric diarrhoea, 2017 and 2023\",\"authors\":\"Jing Zhang , Hanyu Wang , Yingling Ni , Zelin Yan , Dan Chi , Kewei Li , Rong Zhang\",\"doi\":\"10.1016/j.ijantimicag.2025.107580\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>To compare the epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant <em>Enterobacteriaceae</em> isolated from pediatric diarrhoea cases in 2017 and 2023.</div></div><div><h3>Methods</h3><div>Fecal samples from children with diarrhoea were collected in Zhejiang, China, in 2017 and 2023. Bacterial isolation, antimicrobial susceptibility testing, and whole-genome sequencing were performed to identify resistance determinants and plasmid types.</div></div><div><h3>Results</h3><div>The prevalence of <em>mcr-1</em>-positive strains declined significantly from 2.36% (25/1059) in 2017 to 0.82% (3/367) in 2023, while <em>tet</em>(X4)-positive strains rose from 0% to 1.91% (7/367). Carbapenemase-producers remained rare (0.28% in 2017; 1.63% in 2023), with <em>bla</em><sub>NDM</sub> as the dominant carbapenemase gene. Whole genome sequencing revealed diverse antimicrobial resistance genes (ARGs) and evolving plasmid types. Notably, by 2023, all <em>mcr-1</em> were carried on IncI2 plasmids. Conjugation experiments confirmed plasmids carrying <em>mcr-1, bla</em><sub>NDM-5</sub>, and <em>tet</em>(X4) are transferable to a recipient strain.</div></div><div><h3>Conclusions</h3><div>The rising prevalence of multidrug-resistant Enterobacteriaceae in pediatric diarrhoea highlights the urgent need for continuous surveillance and effective infection control measures.</div></div>\",\"PeriodicalId\":13818,\"journal\":{\"name\":\"International Journal of Antimicrobial Agents\",\"volume\":\"66 5\",\"pages\":\"Article 107580\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Antimicrobial Agents\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0924857925001359\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Antimicrobial Agents","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0924857925001359","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

摘要

儿童抗菌素耐药性（AMR）感染的日益流行正成为全球日益关注的问题。抗生素耐药性对儿童腹泻构成了重大挑战，其中耐多药肠杆菌科威胁到治疗效果。本研究调查了2017年（n=1059）和2023年（n=367）从儿童腹泻病例中分离出的碳青霉烯类、替加环素类和多粘菌素类耐药肠杆菌科的流行情况、耐药机制和遗传特征。mcr-1阳性株流行率由2017年的2.36%（25/1059）下降至2023年的0.82% (3/367),tet（X4）阳性株流行率由0%上升至1.91%（7/367）。碳青霉烯酶生产商仍然很少见(2017年为0.28%；2023年为1.63%)，其中blaNDM为碳青霉烯酶显性基因。全基因组测序揭示了多种抗菌素耐药基因（ARGs）和不断进化的质粒类型。值得注意的是，到2023年，所有mcr-1都携带在IncI2质粒上。偶联实验证实携带mcr-1、blaNDM-5和tet（X4）的质粒可以转移到受体菌株上，这突出了水平基因转移的潜力。我们的研究结果表明，从2017年到2023年，儿童腹泻相关肠杆菌科耐药性谱发生了重大变化。mcr-1的下降反映了多粘菌素使用减少的影响，而tet（X4）的上升则标志着一个新的挑战。这些发现强调了儿科肠杆菌科抗生素耐药性的动态性质，并强调了严格的抗菌药物管理和监测的必要性。“同一个健康”方针将临床、农业和环境方面的努力结合起来，对于在全球范围内减轻抗生素耐药性传播和保护儿童健康至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Comparative epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant Enterobacteriaceae in pediatric diarrhoea, 2017 and 2023

查看原文本刊更多论文

Comparative epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant Enterobacteriaceae in pediatric diarrhoea, 2017 and 2023

Objectives

To compare the epidemiology and resistance mechanisms of carbapenem-, tigecycline-, and polymyxin-resistant Enterobacteriaceae isolated from pediatric diarrhoea cases in 2017 and 2023.

Methods

Fecal samples from children with diarrhoea were collected in Zhejiang, China, in 2017 and 2023. Bacterial isolation, antimicrobial susceptibility testing, and whole-genome sequencing were performed to identify resistance determinants and plasmid types.

Results

The prevalence of mcr-1-positive strains declined significantly from 2.36% (25/1059) in 2017 to 0.82% (3/367) in 2023, while tet(X4)-positive strains rose from 0% to 1.91% (7/367). Carbapenemase-producers remained rare (0.28% in 2017; 1.63% in 2023), with bla_NDM as the dominant carbapenemase gene. Whole genome sequencing revealed diverse antimicrobial resistance genes (ARGs) and evolving plasmid types. Notably, by 2023, all mcr-1 were carried on IncI2 plasmids. Conjugation experiments confirmed plasmids carrying mcr-1, bla_NDM-5, and tet(X4) are transferable to a recipient strain.

Conclusions

The rising prevalence of multidrug-resistant Enterobacteriaceae in pediatric diarrhoea highlights the urgent need for continuous surveillance and effective infection control measures.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International Journal of Antimicrobial Agents 医学-传染病学

CiteScore

21.60

自引率

0.90%

发文量

176

审稿时长

36 days

期刊介绍： The International Journal of Antimicrobial Agents is a peer-reviewed publication offering comprehensive and current reference information on the physical, pharmacological, in vitro, and clinical properties of individual antimicrobial agents, covering antiviral, antiparasitic, antibacterial, and antifungal agents. The journal not only communicates new trends and developments through authoritative review articles but also addresses the critical issue of antimicrobial resistance, both in hospital and community settings. Published content includes solicited reviews by leading experts and high-quality original research papers in the specified fields.