阿尔及利亚奇异变形杆菌临床分离株中新出现的多药耐药性的分子驱动因素。

Molecular drivers of emerging multidrug resistance in Proteus mirabilis clinical isolates from Algeria.

机构信息

Laboratory of Natural Bioresources, Department of Biology, Faculty of Natural Sciences and Life, University of Hassiba Benbouali Chlef, Box 151, 02000 Chlef, AlgeriaAlgeria.

出版信息

J Glob Antimicrob Resist. 2019 Sep;18:249-256. doi: 10.1016/j.jgar.2019.01.030. Epub 2019 Feb 21.

DOI:10.1016/j.jgar.2019.01.030

PMID:30797091

Abstract

OBJECTIVES

The aim of this study was to characterise the molecular drivers of multidrug resistance in Proteus mirabilis isolated from Algerian community and hospital patients.

METHODS

A total of 166 P. mirabilis isolates were collected from two hospitals and eight private laboratories from four cities (Khemis Miliana, Aïn Defla, Oran and Chlef) located in northwestern Algeria. All isolates were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Antimicrobial susceptibility testing was performed by the disk diffusion and Etest methods. Genes encoding AmpC β-lactamases, extended-spectrum β-lactamases (ESBLs), quinolone resistance and aminoglycoside-modifying enzymes (AMEs) as well as plasmid replicon typing were characterised by PCR. Clonal relationships were also determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) typing and were compared with MALDI-TOF/MS proteomic typing.

RESULTS

Of the 166 P. mirabilis isolates, 14 (8.4%) exhibited resistance to important antibiotics, including amoxicillin, amoxicillin/clavulanic acid, cefotaxime, gentamicin and ciprofloxacin, of which 4/14 (28.6%) had an ESBL genotype (bla) and 10 (71.4%) had an AmpC/ESBL genotype (bla/bla). AME genes were detected in all isolates, including ant(2'')-I, aac(3)-I, aac(6')-Ib-cr and aac(3)-IV. The qnrA gene was identified in 13 isolates (7.8%). ERIC-PCR showed one predominant clone, with eight bla-producing isolates from UHC Oran belonging to profile A clustering together in the MALDI-TOF/MS dendrogram.

CONCLUSION

Here we report the first description of AME and plasmid-mediated quinolone resistance genes among ESBL- and/or AmpC β-lactamase-producing P. mirabilis isolates from community- and hospital-acquired infections in northwestern Algeria.

摘要

目的

本研究旨在描述从阿尔及利亚社区和医院患者中分离的奇异变形杆菌的多药耐药的分子驱动因素。

方法

从位于阿尔及利亚西北部的四个城市（Khemis Miliana、Aïn Defla、Oran 和 Chlef）的两家医院和八家私人实验室共收集了 166 株奇异变形杆菌。所有分离株均通过基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF/MS）进行鉴定。采用纸片扩散法和 Etest 法进行抗菌药物敏感性试验。采用 PCR 方法检测 AmpC β-内酰胺酶、超广谱β-内酰胺酶（ESBLs）、喹诺酮耐药和氨基糖苷修饰酶（AMEs）基因以及质粒复制子分型。通过肠杆菌重复基因间一致性 PCR（ERIC-PCR）分型还确定了克隆关系，并与 MALDI-TOF/MS 蛋白质组学分型进行了比较。

结果

在 166 株奇异变形杆菌中，有 14 株（8.4%）对包括阿莫西林、阿莫西林/克拉维酸、头孢噻肟、庆大霉素和环丙沙星在内的重要抗生素表现出耐药性，其中 4/14 株（28.6%）具有 ESBL 基因型（bla），10 株（71.4%）具有 AmpC/ESBL 基因型（bla/bla）。所有分离株均检测到 AME 基因，包括 ant（2'）-I、aac（3）-I、aac（6'）-Ib-cr 和 aac（3）-IV。在 13 株菌中鉴定出 qnrA 基因（7.8%）。ERIC-PCR 显示一个主要的克隆，来自 UHC Oran 的 8 株产生 bla 的分离株属于 A 型聚类，在 MALDI-TOF/MS 树状图中聚在一起。