铜绿假单胞菌 O 抗原血清型、耐药谱与高危克隆之间的关联：来自西班牙全国性调查的结果。

Association between Pseudomonas aeruginosa O-antigen serotypes, resistance profiles and high-risk clones: results from a Spanish nationwide survey.

机构信息

Servicio de Microbiología, Hospital Son Espases, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, España.

Servicio de Microbiología, Hospital Universitario La Coruña, Instituto Investigación Biomédica A Coruña (INIBIC), A Coruña, España.

出版信息

J Antimicrob Chemother. 2019 Nov 1;74(11):3217-3220. doi: 10.1093/jac/dkz346.

DOI:10.1093/jac/dkz346

PMID:31430372

Abstract

OBJECTIVES

To evaluate the correlation of O-antigen serotypes with resistance profiles and high-risk clones in a Spanish nationwide survey.

METHODS

Up to 30 consecutive healthcare-associated Pseudomonas aeruginosa isolates were collected during October 2017 from each of 51 hospitals (covering all Spanish regions) with a total of 1445 isolates studied. MICs of 13 antipseudomonal agents and MDR/XDR profiles had been previously determined, as well as whole-genome sequences of 185 representative XDR isolates. O-antigen serotypes (O1-O16) were determined by agglutination using serotype-specific antisera (BioRad). The Pseudomonas aeruginosa serotyper (PAst) program was used for in silico serotyping.

RESULTS

The most frequent serotypes were O6 (17.8%), O1 (15.4%) and O11 (13.3%). In contrast, the most frequent serotype among XDR isolates (17.3%) was O4 (34.1%), distantly followed by O11 (15.9%). Within serotypes, XDR phenotypes were more frequent for O12 (60.0%) and O4 (57.3%). The most frequent clone among the XDR isolates was ST175 (40.9%), followed by CC235 (10.7%), ST308 (5.2%) and CC111 (3.6%). Up to 81.6% of XDR ST175 isolates typed O4, whereas 18.4% were non-typeable. O4 genotype was detected in all sequenced (n=55) ST175 isolates. On the other hand, CC235 and ST308 were associated with O11, whereas CC111 was linked to serotype O12.

CONCLUSIONS

O4 serotype is linked to the MDR/XDR profile of widespread ST175 (typically only susceptible to colistin, amikacin and the novel combinations ceftolozane/tazobactam and ceftazidime/avibactam) and therefore, after local validation, its detection in the microbiology laboratory might be useful for guiding semi-empirical antipseudomonal therapies and infection control measures in Spanish hospitals.

摘要

目的

评估西班牙全国性调查中 O 抗原血清型与耐药谱和高危克隆之间的相关性。

方法

2017 年 10 月，从覆盖西班牙所有地区的 51 家医院（每家医院采集 30 株连续的医源性铜绿假单胞菌分离株）共采集了 1445 株铜绿假单胞菌分离株。此前已测定了 13 种抗假单胞菌药物的 MIC 值和 MDR/XDR 谱，以及 185 株 XDR 分离株的全基因组序列。使用血清型特异性抗血清（BioRad）通过凝集试验确定 O 抗原血清型（O1-O16）。使用 Pseudomonas aeruginosa serotyper（PAst）程序进行计算机血清分型。

结果

最常见的血清型是 O6（17.8%）、O1（15.4%）和 O11（13.3%）。相比之下，XDR 分离株中最常见的血清型（17.3%）是 O4（34.1%），其次是 O11（15.9%）。在血清型内，O12（60.0%）和 O4（57.3%）的 XDR 表型更为常见。XDR 分离株中最常见的克隆是 ST175（40.9%），其次是 CC235（10.7%）、ST308（5.2%）和 CC111（3.6%）。高达 81.6%的 XDR ST175 分离株为 O4 型，而 18.4%为非定型。在所有测序的（n=55）ST175 分离株中均检测到 O4 基因型。另一方面，CC235 和 ST308 与 O11 相关，而 CC111 与 O12 型相关。