Department of Infectious Diseases and LIM-54, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar 470, São Paulo - SP, 05403-000, Brazil.
Department of Infectious Diseases and LIM-54, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar 470, São Paulo - SP, 05403-000, Brazil; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Rua Dr Ovídio Pires de Campos 225, Sala 629, São Paulo - SP, 05403-010, Brazil.
J Glob Antimicrob Resist. 2019 Mar;16:147-149. doi: 10.1016/j.jgar.2018.12.021. Epub 2019 Jan 8.
Pseudomonas aeruginosa is a Gram-negative bacterium that causes severe infections, especially in hospitalised and immunocompromised patients. Polymyxins are the last therapeutic option to treat infections caused by this micro-organism. Here we describe a polymyxin-resistant P. aeruginosa assigned as sequence type (ST) 245 for the first time in Brazil.
Antimicrobial susceptibility testing of the isolate was performed. In addition, whole-genome sequencing was performed and its virulence and resistance genes were analysed.
The P. aeruginosa ST245 isolate was identified for the first time in Brazil in a patient with ventilator-associated pneumonia hospitalised at Hospital das Clínicas, São Paulo. Analysis of the genome showed the presence of several resistance and virulence genes. Mutations in β-lactam resistance genes were found in β-lactamases, outer membrane proteins, efflux pump and penicillin-binding proteins. Polymorphisms related to pathways leading to polymyxin resistance are also present, such as lipid A or keto-deoxyoctulosonate modification with aminoarabinose as well as activation of lipopolysaccharide (LPS).
Such findings may represent an alert for the spread of an unusual profile in the country.
铜绿假单胞菌是一种革兰氏阴性细菌，可导致严重感染，尤其是在住院和免疫功能低下的患者中。多粘菌素是治疗该微生物引起的感染的最后一种治疗选择。在这里，我们首次在巴西描述了一种多粘菌素耐药的铜绿假单胞菌，其序列类型（ST）为 245。
对分离株进行了抗菌药物敏感性测试。此外，还进行了全基因组测序，并对其毒力和耐药基因进行了分析。
首次在巴西圣保罗临床医院住院的呼吸机相关性肺炎患者中发现了铜绿假单胞菌 ST245 分离株。对基因组的分析显示存在多种耐药和毒力基因。在β-内酰胺酶、外膜蛋白、外排泵和青霉素结合蛋白中发现了β-内酰胺类耐药基因的突变。与导致多粘菌素耐药的途径相关的多态性也存在，如脂质 A 或酮-脱氧辛糖酸盐与氨基阿拉伯糖的修饰以及脂多糖（LPS）的激活。
这些发现可能表明该国出现了一种不寻常的耐药模式。
