囊性纤维化患者中一株非典型、高度耐药、克隆性铜绿假单胞菌的分子检测。
Molecular detection of an atypical, highly resistant, clonal Pseudomonas aeruginosa isolate in cystic fibrosis patients.
机构信息
Department of Medical Microbiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Department of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
出版信息
J Cyst Fibros. 2013 Mar;12(2):141-6. doi: 10.1016/j.jcf.2012.07.007. Epub 2012 Aug 16.
BACKGROUND
The identification of Pseudomonas aeruginosa (P. aeruginosa) isolates in sputum from cystic fibrosis (CF) patients can be challenging due to the multitude of phenotypic changes isolates undergo during adaptation to the microenvironment of the CF lung.
METHODS
We report the occurrence of shared P. aeruginosa isolates which failed identification by phenotypic methodologies and required species specific polymerase chain reaction. P. aeruginosa isolates were genotyped by macrorestriction analysis.
RESULTS
Analysis of atypical isolates revealed one clonal P. aeruginosa isolate and three smaller clusters. In contrast molecular typing of phenotypically characteristic P. aeruginosa isolates revealed only small clusters. Despite exhibiting higher levels of antimicrobial resistance, acquisition of atypical strains was not associated with significant changes in clinical decline.
CONCLUSIONS
Our experience highlights the importance of accurate identification of bacterial isolates in CF lung disease to detect clonal spread of atypical isolates.
背景
由于假单胞菌（P. aeruginosa）在囊性纤维化（CF）患者的痰液中经历了多种表型变化，因此鉴定这些细菌可能具有挑战性。这些变化是由于 CF 肺部微环境的适应所致。
方法
我们报告了一些假单胞菌分离株的发生情况，这些分离株无法通过表型方法鉴定，需要使用物种特异性聚合酶链反应。使用宏限制分析对假单胞菌分离株进行了基因分型。
结果
对非典型分离株的分析显示出一个克隆假单胞菌分离株和三个较小的簇。相比之下，表型特征明显的假单胞菌分离株的分子分型仅显示出小簇。尽管表现出更高水平的抗菌药物耐药性，但获得非典型菌株与临床病情恶化没有显著关联。
结论
我们的经验强调了在 CF 肺部疾病中准确鉴定细菌分离株以检测非典型分离株的克隆传播的重要性。
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