Nemec Alexandr, Dijkshoorn Lenie, van der Reijden Tanny J K
National Institute of Public Health, Šrobárova 48, 100 42 Prague, Czech Republic 2Department of Infectious Diseases, Leiden University Medical Center C5-P, PO Box 9600, 2300 RC Leiden, the Netherlands.
J Med Microbiol. 2004 Feb;53(Pt 2):147-153. doi: 10.1099/jmm.0.05445-0.
In a recent study, a large proportion of multi-drug-resistant (MDR) Acinetobacter baumannii strains that were isolated from hospitalized patients in the Czech Republic was found to belong to two major groups (A and B). These groups appeared to be similar to epidemic clones I and II, respectively, which were identified previously among outbreak strains from north-western European hospitals. The aim of the present study was to assess in detail the genetic relatedness of Czech A. baumannii strains and those of epidemic clones I and II by using ribotyping with HindIII and HincII and by AFLP fingerprinting. The study collection included 70 MDR strains that were isolated in 30 Czech hospitals in 1991-2001, 15 susceptible Czech strains from 1991 to 1996 and 13 reference strains of clones I and II from 1982 to 1990. One major HindIII/HincIII ribotype (R1-1) was observed in 38 MDR Czech strains and eight reference strains of clone I, whereas another major ribotype (R2-2) was observed in 11 MDR Czech strains and in three reference strains of clone II. A selection of 59 Czech strains (representative of all ribotypes) and the 13 reference strains were investigated by AFLP fingerprinting. At a clustering level of 83%, two large clusters could be distinguished: cluster 1 included all reference strains of clone I and 25 MDR Czech strains, whilst cluster 2 contained all reference strains of clone II and 11 MDR Czech strains. There was a clear correlation between the groupings by AFLP analysis and by ribotyping, as all strains with ribotype R1-1 and four strains with slightly different ribotypes were found in AFLP cluster 1, whereas all strains with ribotype R2-2 and seven strains with similar ribotypes were in AFLP cluster 2. Thus, 41 and 21 MDR Czech strains could be classified as belonging to clones I and II, respectively. The remaining eight MDR and 15 susceptible strains were highly heterogeneous and were distinct from clones I and II by both AFLP fingerprinting and ribotyping. These results indicate that the two predominant groups observed among MDR Czech A. baumannii strains from the 1990s are genetically congruent with the north-western European epidemic clones that were found in the 1980s. Recognition of these clinically relevant, widespread clones is important in infection prevention and control; they are also interesting subjects to study genetic mechanisms that give rise to their antibiotic resistance and epidemic behaviour.
在最近一项研究中，从捷克共和国住院患者中分离出的大部分多重耐药鲍曼不动杆菌菌株被发现属于两个主要组（A组和B组）。这些组似乎分别与之前在西北欧医院的暴发菌株中鉴定出的流行克隆I和II相似。本研究的目的是通过使用HindIII和HincII进行核糖体分型以及AFLP指纹图谱分析，详细评估捷克鲍曼不动杆菌菌株与流行克隆I和II的遗传相关性。研究样本包括1991 - 2001年在30家捷克医院分离出的70株多重耐药菌株、1991年至1996年的15株敏感捷克菌株以及1982年至1990年的13株克隆I和II的参考菌株。在38株捷克多重耐药菌株和8株克隆I的参考菌株中观察到一种主要的HindIII/HincIII核糖体分型（R1 - 1），而在11株捷克多重耐药菌株和3株克隆II的参考菌株中观察到另一种主要核糖体分型（R2 - 2）。通过AFLP指纹图谱分析对59株捷克菌株（代表所有核糖体分型）和13株参考菌株进行了研究。在聚类水平为83%时，可以区分出两个大的聚类：聚类1包括克隆I的所有参考菌株和25株捷克多重耐药菌株，而聚类2包含克隆II的所有参考菌株和11株捷克多重耐药菌株。AFLP分析和核糖体分型的分组之间存在明显的相关性，因为在AFLP聚类1中发现了所有核糖体分型为R1 - 1的菌株以及4株核糖体分型略有不同的菌株，而在AFLP聚类2中发现了所有核糖体分型为R2 - 2的菌株以及7株核糖体分型相似的菌株。因此，41株和21株捷克多重耐药菌株可分别归类为属于克隆I和II。其余8株多重耐药菌株和15株敏感菌株高度异质，通过AFLP指纹图谱分析和核糖体分型均与克隆I和II不同。这些结果表明，在20世纪90年代从捷克鲍曼不动杆菌多重耐药菌株中观察到的两个主要组在遗传上与20世纪80年代发现的西北欧流行克隆一致。识别这些临床相关的广泛传播的克隆对于感染预防和控制很重要；它们也是研究导致其抗生素耐药性和流行行为的遗传机制的有趣对象。
