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2001 - 2009年莫桑比克南部幼儿社区获得性菌血症的分子特征

Molecular Characterization of Community Acquired Bacteremia in Young Children in Southern Mozambique, 2001-2009.

作者信息

Vubil Delfino, Garrine Marcelino, Ruffing Ulla, Acácio Sozinho, Sigaúque Betuel, Alonso Pedro L, von Müller Lutz, Herrmann Mathias, Mandomando Inácio

机构信息

Centro de Investigação em Saúde de Manhiça (CISM)Maputo, Mozambique.

Institute of Medical Microbiology and Hygiene, University of SaarlandHomburg, Germany.

出版信息

Front Microbiol. 2017 May 4;8:730. doi: 10.3389/fmicb.2017.00730. eCollection 2017.

Abstract

The emergence of community-acquired infections is increasingly recognized as life threating problem worldwide. In Manhiça district, southern Mozambique, is the leading cause of community-acquired bacteremia in neonates. Eighty-four isolates from children less than 5 years admitted to Manhiça District Hospital from 2001 to 2009 were randomly selected and genetically characterized by DNA microarray and typing. Antimicrobial susceptibility was determined by VITEK 2. Thirty-eight different types and 14 clonal complexes (CC) were identified. -type t084 ( = 10; 12%) was the most predominant while CC8 ( = 18; 21%) and CC15 ( = 14; 16%) were the most frequent CCs. Mortality tended to be higher among children infected with CC45 (33.3%, 1/3) and CC8 (27.8%, 5/18). The majority of isolates possessed the accessory gene regulator I (45%) and belonged to either capsule type 8 (52%) or 5 (47%). Panton valentine leukocidin (PVL) encoding genes were detected in 30%. Antibiotic resistance was high for penicillin (89%), tetracycline (59%) and Trimethoprim Sulfamethoxazole (36%) while MRSA was uncommon (8%). Although MRSA were uncommon, we found high genetic diversity of methicillin susceptible causing bacteremia in Mozambican children, associated with high resistance to the most available antibiotics in this community. Some CCs are likely to be more lethal indicating the need for prompt recognition and appropriate treatment.

摘要

社区获得性感染的出现日益被视为全球范围内威胁生命的问题。在莫桑比克南部的曼希卡区,它是新生儿社区获得性菌血症的主要原因。从2001年到2009年入住曼希卡区医院的5岁以下儿童中随机选取84株分离菌,通过DNA微阵列和分型进行基因特征分析。采用VITEK 2测定抗菌药物敏感性。鉴定出38种不同类型和14个克隆复合体(CC)。t084型(n = 10;12%)最为常见,而CC8(n = 18;21%)和CC15(n = 14;16%)是最常见的CC。感染CC45(33.3%,1/3)和CC8(27.8%,5/18)的儿童死亡率往往更高。大多数分离菌具有辅助基因调节因子I(45%),属于8型(52%)或5型(47%)荚膜。30%的菌株检测到杀白细胞素(PVL)编码基因。青霉素(89%)、四环素(59%)和复方新诺明(36%)的耐药率较高,而耐甲氧西林金黄色葡萄球菌(MRSA)不常见(8%)。虽然MRSA不常见,但我们发现莫桑比克儿童中引起菌血症的甲氧西林敏感金黄色葡萄球菌存在高度遗传多样性,且对该社区最常用的抗生素耐药性高。一些CC可能更具致死性,这表明需要及时识别和适当治疗。

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