Annavajhala Medini K, Gomez-Simmonds Angela, Uhlemann Anne-Catrin
Division of Infectious Diseases, Department of Medicine, Columbia University, New York, NY, United States.
Front Microbiol. 2019 Jan 31;10:44. doi: 10.3389/fmicb.2019.00044. eCollection 2019.
The complex (ECC) includes common nosocomial pathogens capable of producing a wide variety of infections. Broad-spectrum antibiotic resistance, including the recent emergence of resistance to last-resort carbapenems, has led to increased interest in this group of organisms and carbapenem-resistant complex (CREC) in particular. Molecular typing methods based on heat-shock protein sequence, pulsed-field gel electrophoresis, comparative genomic hybridization, and, most recently, multilocus sequence typing have led to the identification of over 1069 ECC sequence types in 18 phylogenetic clusters across the globe. Whole-genome sequencing and comparative genomics, moreover, have facilitated global analyses of clonal composition of ECC and specifically of CREC. Epidemiological and genomic studies have revealed diverse multidrug-resistant ECC clones including several potential epidemic lineages. Together with intrinsic β-lactam resistance, members of the ECC exhibit a unique ability to acquire genes encoding resistance to multiple classes of antibiotics, including a variety of carbapenemase genes. In this review, we address recent advances in the molecular epidemiology of multidrug-resistant complex, focusing on the global expansion of CREC.
肠杆菌科复合体（ECC）包括能够引发多种感染的常见医院病原体。广泛的抗生素耐药性，包括最近出现的对作为最后手段的碳青霉烯类药物的耐药性，使得人们对这组微生物，尤其是耐碳青霉烯类肠杆菌科复合体（CREC）越来越感兴趣。基于热休克蛋白序列、脉冲场凝胶电泳、比较基因组杂交以及最近的多位点序列分型的分子分型方法，已在全球18个系统发育簇中鉴定出超过1069种ECC序列类型。此外，全基因组测序和比较基因组学有助于对ECC尤其是CREC的克隆组成进行全球分析。流行病学和基因组学研究揭示了多种耐多药ECC克隆，包括几个潜在的流行谱系。除了固有的β-内酰胺耐药性外，ECC成员还具有独特的能力，能够获得编码对多种抗生素耐药性的基因，包括多种碳青霉烯酶基因。在本综述中，我们阐述了耐多药肠杆菌科复合体分子流行病学的最新进展，重点关注CREC的全球传播情况。
