Department of Bacteriology and Infection Control, University Hospital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France.
Service d'anesthésie-réanimation chirurgicale, unité d'anesthésie-réanimation chirurgicale cardio-vasculaire, DHU A-TVB, University Hospital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France.
J Hosp Infect. 2020 Jan;104(1):33-39. doi: 10.1016/j.jhin.2019.07.014. Epub 2019 Jul 29.
Pseudomonas aeruginosa is a major bacterial pathogen responsible for hospital-acquired infections. Although its epidemiology is considered as non-clonal, certain international high-risk multidrug-resistant clones have been recognized.
From the first report of an intra-hospital outbreak due to an SHV2a-producing P. aeruginosa strain, to describe the emergence of a new ST235-specific lineage harbouring this rare extended-spectrum β-lactamase (ESBL).
Between May and October 2018, four patients hospitalized in the cardiovascular intensive care unit of a French teaching hospital were infected by a multidrug-resistant P. aeruginosa isolate. Serotype and antimicrobial susceptibility were tested; multi-locus sequence type (MLST), core genome MLST, and resistome were determined through whole genome sequencing. A phylogenetic analysis based on single nucleotide polymorphism was performed using available ST235 genomes.
The four strains were susceptible to colistin, ciprofloxacin, ceftazidime-avibactam, and ceftolozane-tazobactam. bla was identified in each genome of this ST235-O11 serotype cluster that showed an identical cgMLST profile (0-2 out of 4162 different alleles). The phylogenic analysis of 162 ST235 genomes showed that only four other strains harboured a bla, originating from France and USA, clustering together although being different from the outbreak strains.
Among the ST235 P. aeruginosa strains, a sub-lineage sharing a common genetic background and harbouring the bla ESBL seems to emerge from different locations, yielding secondary local outbreaks.
铜绿假单胞菌是一种主要的细菌病原体，可导致医院获得性感染。尽管其流行病学被认为是非克隆的，但已经认识到某些国际高风险多药耐药克隆。
从首次报告由产 SHV2a 的铜绿假单胞菌菌株引起的医院内暴发开始，描述携带这种罕见的扩展谱β-内酰胺酶（ESBL）的新型 ST235 特异性谱系的出现。
2018 年 5 月至 10 月期间，法国一所教学医院的心血管重症监护病房的 4 名患者感染了一种多药耐药铜绿假单胞菌分离株。测试血清型和抗菌药物敏感性；通过全基因组测序确定多位点序列型（MLST）、核心基因组 MLST 和抗性组。使用可用的 ST235 基因组进行基于单核苷酸多态性的系统发育分析。
这四种菌株对多粘菌素、环丙沙星、头孢他啶-阿维巴坦和头孢洛扎-他唑巴坦敏感。在该 ST235-O11 血清型群的每个基因组中都鉴定出 bla，该群显示出相同的 cgMLST 图谱（4162 个不同等位基因中有 0-2 个）。对 162 个 ST235 基因组的系统发育分析表明，只有另外四个菌株携带 bla，它们起源于法国和美国，尽管与暴发菌株不同，但聚集在一起。
在 ST235 铜绿假单胞菌菌株中，似乎出现了一个具有共同遗传背景并携带 bla ESBL 的亚谱系，从不同地点产生了继发性局部暴发。
