Gentile Bernardina, Grottola Antonella, Orlando Gabriella, Fregni Serpini Giulia, Venturelli Claudia, Meschiari Marianna, Anselmo Anna, Fillo Silvia, Fortunato Antonella, Lista Florigio, Pecorari Monica, Mussini Cristina
Scientific Department, Army Medical Center, Via Santo Stefano Rotondo 4, 00184 Rome, Italy.
Molecular Microbiology and Virology Unit, University Hospital Policlinico Modena, Via Del Pozzo, 71, 41124 Modena, Italy.
Antibiotics (Basel). 2020 May 12;9(5):246. doi: 10.3390/antibiotics9050246.
Multidrug-resistant (MDR ), in particular carbapenem-resistant (CR-), has become endemic in Italy, where alarming data have been reported on the spread of colistin-resistant CR- (CRCR-). During the period 2013-2014, 27 CRCR- nosocomial strains were isolated within the Modena University Hospital Policlinico (MUHP) multidrug resistance surveillance program. We retrospectively investigated these isolates by whole-genome sequencing (WGS) analysis of the resistome, virulome, plasmid content, and core single nucleotide polymorphisms (cSNPs) in order to gain insights into their molecular epidemiology. The in silico WGS analysis of the resistome revealed the presence of genes, such as , related to the phenotypically detected resistances to carbapenems. Concerning colistin resistance, the plasmidic genes were not detected, while known and new genetic variations in , , and were found. The virulome profile revealed the presence of type-3 fimbriae, capsular polysaccharide, and iron acquisition system genes. The detected plasmid replicons were classified as , , , , and types. The cSNPs genotyping was consistent with the multi locus sequence typing (MLST) and with the distribution of mutations related to colistin resistance genes. In a nosocomial drug resistance surveillance program, WGS proved to be a useful tool for elucidating the spread dynamics of CRCR- nosocomial strains and could help to limit their diffusion.
多重耐药（MDR），尤其是耐碳青霉烯类（CR-），在意大利已成为地方病，该国已报告了有关耐黏菌素的CR-（CRCR-）传播的惊人数据。在2013 - 2014年期间，在摩德纳大学医院综合医院（MUHP）的多重耐药监测项目中分离出27株CRCR-医院菌株。我们通过对耐药组、毒力组、质粒含量和核心单核苷酸多态性（cSNP）进行全基因组测序（WGS）分析，对这些分离株进行了回顾性研究，以便深入了解它们的分子流行病学。对耐药组的计算机WGS分析揭示了与表型检测到的对碳青霉烯类耐药相关的基因，如 。关于黏菌素耐药性，未检测到质粒基因 ，但在 、 和 中发现了已知和新的基因变异。毒力组图谱显示存在3型菌毛、荚膜多糖和铁摄取系统基因。检测到的质粒复制子被分类为 、 、 、 和 类型。cSNP基因分型与多位点序列分型（MLST）以及与黏菌素耐药基因相关的突变分布一致。在医院耐药监测项目中，WGS被证明是阐明CRCR-医院菌株传播动态的有用工具，有助于限制其扩散。
