中国南方儿科患者中出现的耐碳青霉烯类XDR肠炎沙门氏菌：一项基因组研究

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Antimicrobial Agents Pub Date : 2025-08-06 DOI:10.1016/j.ijantimicag.2025.107589

Xueqin Feng , Shengkai Li , Dingjie Huang , Nan Tan , Xueer Li , Shuting Xia , Lulu Hu , Rui Cai , Yinghui Li , Juan Wang , Miaomiao Luo , Huimin Li , Xiaolang Ye , Ziquan Lv , Xiaolu Shi , Shuang Wu , Nigel Dyer , Heng Li , Qinghua Hu , Zhemin Zhou

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引用次数: 0

摘要

背景与目的：耐碳青霉烯肠沙门氏菌（CRSE）主要由质粒驱动，对公共卫生构成日益严重的威胁，特别是在儿科人群中。本研究调查了儿科人群中的一组儿科CRSE感染，描述了CRSE分离株的基因组特征，评估了全球CRSE患病率，并探讨了质粒介导的水平基因转移。方法：对18例小儿CRSE病例进行流行病学调查。基因组分析包括抗性组分析、质粒分型和系统发育聚类来评估遗传多样性。530113个沙门氏菌基因组的全球分析鉴定出携带碳青霉烯酶的分离株。通过质粒在大肠杆菌和大肠杆菌间的转移实验，评估基因的水平传播。结果：呼吸道合并感染（67%的病例，主要是RSV和hpiv）与严重的临床结果相关。基因组分析显示，多个基因上不同的CRSE克隆携带blaNDM-5，主要在inci - γ /K1和IncHI2A质粒上。质粒介导的肠链球菌和大肠杆菌之间碳青霉烯耐药基因的转移得到证实。全球监测发现了228株碳青霉烯酶阳性沙门氏菌分离株（2000-2023），分布在35个遗传多样性人群和24个国家，表明传播广泛。结论：呼吸道合并感染可加重儿童CRSE的严重程度，质粒循环驱动碳青霉烯类耐药传播。CRSE的高度遗传多样性和全球分布突出了对综合监测、抗菌药物管理和针对合并感染和环境宿主的干预措施的迫切需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Emergence of carbapenem-resistant XDR Salmonella enterica in paediatric patients in South China: A genomic perspective study

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Emergence of carbapenem-resistant XDR Salmonella enterica in paediatric patients in South China: A genomic perspective study

Background and Aim

Carbapenem-resistant Salmonella enterica (CRSE), mostly driven by plasmids, poses a growing public health threat, especially in paediatric populations. This study investigates a cluster of paediatric CRSE infections in paediatric populations, characterizes genomic features of CRSE isolates, assesses global CRSE prevalence, and explores plasmid-mediated horizontal gene transfer.

Methods

An epidemiological investigation of 18 paediatric CRSE cases was conducted. Genomic analysis included resistome profiling, plasmid typing, and phylogenetic clustering to assess genetic diversity. A global analysis of 530 113 Salmonella genomes identified carbapenemase-carrying isolates. Plasmid transfer experiments between S. enterica and Escherichia coli were performed to evaluate horizontal gene transmission.

Results

Respiratory co-infections (67% of cases, primarily respiratory syncytial virus and human parainfluenza viruses) were associated with severe clinical outcomes. Genomic analysis revealed multiple genetically distinct CRSE clones carrying bla_NDM-5, predominantly on IncI-gamma/K1 and IncHI2A plasmids. Plasmid-mediated transfer of carbapenem resistance genes between S. enterica and E. coli was confirmed. Global surveillance identified 228 carbapenemase-positive Salmonella isolates (2000–2023) across 35 genetically diverse populations and 24 countries, demonstrating widespread dissemination.

Conclusions

Respiratory co-infections may exacerbate CRSE severity in children, while plasmid circulation drives carbapenem resistance transmission. The high genetic diversity and global distribution of CRSE highlight urgent needs for integrated surveillance, antimicrobial stewardship, and interventions targeting co-infections and environmental reservoirs.

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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.