使用基于bla(OXA - 51样)序列分型法对黎巴嫩的黎波里不同医院鲍曼不动杆菌进行分子流行病学研究
Molecular epidemiology of Acinetobacter baumannii in different hospitals in Tripoli, Lebanon using bla(OXA-51-like) sequence based typing.
作者信息
Rafei Rayane, Pailhoriès Hélène, Hamze Monzer, Eveillard Matthieu, Mallat Hassan, Dabboussi Fouad, Joly-Guillou Marie-Laure, Kempf Marie
机构信息
ATOMycA, Inserm Atip-Avenir Team, CRCNA, Inserm U892, 6299 CNRS, University and Centre Hospitalier Universitaire d'Angers, Angers, France.
Laboratoire Microbiologie Santé et Environnement (LMSE), Centre AZM pour la recherche en Biotechnologie et ses applications, Université Libanaise, Tripoli, Lebanon.
出版信息
BMC Microbiol. 2015 May 16;15:103. doi: 10.1186/s12866-015-0441-5.
BACKGROUND
A. baumannii has emerged as an important nosocomial pathogen with an outstanding ability to acquire multidrug resistant mechanisms. In this study, we investigate the molecular epidemiology and carbapenem resistance mechanisms of A. baumannii in Tripoli, Northern Lebanon.
METHODS
One hundred sixteen non-duplicate isolates isolated between 2011 and 2013 in different hospitals in Tripoli, Lebanon from Lebanese patients and wounded Syrian patients during Syrian war were studied. Antibiotic susceptibility testing was determined by agar disc diffusion and Etest. Carbapenemase-encoding genes were investigated by PCR. All isolates were typed by bla OXA-51-like sequence based typing (SBT) and 57 isolates were also analysed by MLST using Pasteur's scheme followed by eBURST analysis.
RESULTS
Of the 116 isolates, 70 (60 %) showed a carbapenem resistance phenotype. The bla OXA-23 with an upstream insertion of ISAba1 was the major carbapenem resistance mechanism and detected in 65 isolates. Five isolates, including four from wounded Syrian patients and one from a Lebanese patient, were positive for bla NDM-1. bla OXA-51-like SBT revealed the presence of 14 variants, where bla OXA-66 was the most common and present in 73 isolates, followed by bla OXA-69 in 20 isolates. MLST analysis identified 17 sequence types (ST) and showed a concordance with bla OXA-51-like SBT. Each clonal complex (CC) had a specific bla OXA-51-like sequence such as CC2, which harboured bla OXA-66 variant, and CC1 harbouring bla OXA-69 variant. NDM-1 producing isolates belonged to ST85 (4 Syrian isolates) and ST25 (1 Lebanese isolate).
CONCLUSIONS
Our results showed a successful predominance of international clone 2 with a widespread occurrence of OXA-23 carbapenemase in Lebanese hospitals. These findings emphasise the urgent need of effective measures to control the spread of A. baumannii in this country.
背景
鲍曼不动杆菌已成为一种重要的医院病原体，具有获得多重耐药机制的显著能力。在本研究中，我们调查了黎巴嫩北部的黎波里地区鲍曼不动杆菌的分子流行病学及碳青霉烯类耐药机制。
方法
对2011年至2013年间在黎巴嫩的黎波里不同医院从黎巴嫩患者以及叙利亚战争期间受伤的叙利亚患者中分离出的116株非重复菌株进行研究。采用琼脂纸片扩散法和Etest法进行药敏试验。通过PCR检测碳青霉烯酶编码基因。所有菌株采用基于bla OXA - 51样序列分型（SBT）进行分型，57株菌株还采用巴斯德方案进行多位点序列分型（MLST）分析，随后进行eBURST分析。
结果
在116株菌株中，70株（60%）表现出碳青霉烯类耐药表型。bla OXA - 23及其上游插入的ISAba1是主要的碳青霉烯类耐药机制，在65株菌株中检测到。5株菌株，包括4株来自受伤叙利亚患者的菌株和1株来自黎巴嫩患者的菌株，bla NDM - 1检测呈阳性。bla OXA - 51样SBT显示存在14种变体，其中bla OXA - 66最为常见，73株菌株中存在该变体，其次是bla OXA - 69，有20株菌株存在该变体。MLST分析鉴定出17种序列类型（ST），并显示与bla OXA - 51样SBT结果一致。每个克隆复合体（CC）都有特定的bla OXA - 51样序列，如携带bla OXA - 66变体的CC2，以及携带bla OXA - 69变体的CC1。产NDM - 1的菌株属于ST85（4株叙利亚菌株）和ST25（1株黎巴嫩菌株）。
结论
我们的结果显示国际克隆2成功占优势，且黎巴嫩医院中OXA - 23碳青霉烯酶广泛存在。这些发现强调迫切需要采取有效措施控制该国鲍曼不动杆菌的传播。
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