Jia Huiqiong, Sun Qingyang, Ruan Zhi, Xie Xinyou
Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Department of Clinical Laboratory, The 117th hospital of People's Liberation Army, Hangzhou, People's Republic of China.
Infect Drug Resist. 2019 Jun 6;12:1545-1553. doi: 10.2147/IDR.S202803. eCollection 2019.
has emerged as an important pathogen associated with hospital- and community-acquired infections. Community-acquired pneumonia is characterized by a fulminant course and high mortality rates. In this study, we report the identification of a community-acquired carbapenem-resistant strain carrying the gene.
This isolate was recovered from a male patient diagnosed with community-acquired pneumonia, septic shock, and respiratory failure. Antimicrobial susceptibility testing were performed and the minimum inhibitory concentrations were determined by the broth microdilution method. Whole-genome sequencing was performed using both long-read MinION and short-read Illumina platforms to fully characterize the -carrying plasmid of the A52. The in silico multilocus sequence typing and genomic epidemiological analysis of the closely related isolates were further elucidated by our recently updated BacWGSTdb server.
The isolate was resistant to meropenem and remained susceptible to several other antimicrobial agents. Whole-genome sequencing and bioinformatics analysis indicated that this isolate belonged to the rare sporadic clone sequence type 880 and the gene was located on the 8,493-bp plasmid pA52-OXA-72. This plasmid exhibited only partial similarity to different OXA-72-encoding plasmids (size range: 8,771-12,056 bp) in various spp. recovered from patients and other reservoirs in different countries.
This study described the first case of fulminant carbapenem-resistant community-acquired pneumonia caused by a rare sporadic clone in China. Adequate surveillance is warranted to monitor the emergence of as a community pathogen.
已成为与医院获得性感染和社区获得性感染相关的重要病原体。社区获得性肺炎的特点是病程急骤且死亡率高。在本研究中，我们报告了一株携带 基因的社区获得性碳青霉烯耐药菌株的鉴定情况。
该 分离株从一名被诊断患有社区获得性肺炎、感染性休克和呼吸衰竭的男性患者身上分离得到。进行了药敏试验，并通过肉汤微量稀释法测定了最低抑菌浓度。使用长读长的MinION平台和短读长的Illumina平台进行全基因组测序，以全面表征A52的携带 的质粒。通过我们最近更新的BacWGSTdb服务器进一步阐明了密切相关分离株的计算机多位点序列分型和基因组流行病学分析。
该分离株对美罗培南耐药，但对其他几种抗菌药物仍敏感。全基因组测序和生物信息学分析表明，该 分离株属于罕见的散发性克隆序列类型880， 基因位于8493 bp的质粒pA52 - OXA - 72上。该质粒与从不同国家的患者和其他宿主中分离出的各种 属中不同的编码OXA - 72的质粒（大小范围：8771 - 12056 bp）仅表现出部分相似性。
本研究描述了中国首例由罕见散发性克隆引起的暴发性碳青霉烯耐药社区获得性 肺炎病例。有必要进行充分的监测，以监测 作为社区病原体的出现情况。
