Tai Anna S, Kidd Timothy J, Whiley David M, Ramsay Kay A, Buckley Cameron, Bell Scott C
1Queensland Children's Medical Research Institute, The University of Queensland, Royal Children's Hospital, Herston 2Adult Cystic Fibrosis Centre, Department of Thoracic Medicine, The Prince Charles Hospital, Chermside 3School of Medicine, The University of Queensland, Brisbane, Qld, Australia.
Pathology. 2015 Feb;47(2):156-60. doi: 10.1097/PAT.0000000000000216.
The aim of this study was to assess the prevalence of acquired carbapenemase genes amongst carbapenem non-susceptible Pseudomonas aeruginosa isolates in Australian patients with cystic fibrosis (CF). Cross-sectional molecular surveillance for acquired carbapenemase genes was performed on CF P. aeruginosa isolates from two isolate banks comprising: (i) 662 carbapenem resistant P. aeruginosa isolates from 227 patients attending 10 geographically diverse Australian CF centres (2007-2009), and (ii) 519 P. aeruginosa isolates from a cohort of 173 adult patients attending one Queensland CF clinic in 2011. All 1189 P. aeruginosa isolates were tested by polymerase chain reaction (PCR) protocols targeting ten common carbapenemase genes, as well the Class 1 integron intI1 gene and the aadB aminoglycoside resistance gene. No carbapenemase genes were identified among all isolates tested. The intI1 and aadB genes were frequently detected and were significantly associated with the AUST-02 strain (OR 24.6, 95% CI 9.3-65.6; p < 0.0001) predominantly from Queensland patients. Despite the high prevalence of carbapenem resistance in P. aeruginosa in Australian patients with CF, no acquired carbapenemase genes were detected in the study, suggesting chromosomal mutations remain the key resistance mechanism in CF isolates. Systematic surveillance for carbapenemase-producing P. aeruginosa in CF by molecular surveillance is ongoing.
本研究的目的是评估澳大利亚囊性纤维化（CF）患者中碳青霉烯类不敏感铜绿假单胞菌分离株中获得性碳青霉烯酶基因的流行情况。对来自两个分离株库的CF铜绿假单胞菌分离株进行了获得性碳青霉烯酶基因的横断面分子监测，这两个分离株库包括：（i）来自澳大利亚10个地理位置不同的CF中心的227例患者的662株碳青霉烯耐药铜绿假单胞菌分离株（2007 - 2009年），以及（ii）2011年来自昆士兰一个CF诊所的173例成年患者队列的519株铜绿假单胞菌分离株。通过针对十个常见碳青霉烯酶基因以及1类整合子intI1基因和aadB氨基糖苷类耐药基因的聚合酶链反应（PCR）方案对所有1189株铜绿假单胞菌分离株进行了检测。在所有检测的分离株中未鉴定出碳青霉烯酶基因。intI1和aadB基因经常被检测到，并且与主要来自昆士兰患者的AUST - 02菌株显著相关（比值比24.6，95%置信区间9.3 - 65.6；p<0.0001）。尽管澳大利亚CF患者中铜绿假单胞菌对碳青霉烯类耐药的患病率很高，但在本研究中未检测到获得性碳青霉烯酶基因，这表明染色体突变仍然是CF分离株中的关键耐药机制。通过分子监测对CF中产生碳青霉烯酶的铜绿假单胞菌进行系统监测正在进行中。
