Guinea Jesús, Arendrup Maiken C, Cantón Rafael, Cantón Emilia, García-Rodríguez Julio, Gómez Ana, de la Pedrosa Elia Gómez G, Hare Rasmus K, Orden Beatriz, Sanguinetti Maurizio, Pemán Javier, Posteraro Brunella, Ruiz-Gaitán Alba, Parisi Gabriella, Da Matta Daniel Archimedes, Colombo Arnaldo L, Sánchez-Carrillo Carlos, Reigadas Elena, Muñoz Patricia, Escribano Pilar
Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
Front Cell Infect Microbiol. 2020 May 5;10:166. doi: 10.3389/fcimb.2020.00166. eCollection 2020.
The objectives of this study were to gain further insight on genotype distribution and percentage of clustered isolates between hospitals and to identify potential clusters involving different hospitals and cities. We aim to genotype spp. isolates causing candidemia in patients admitted to 16 hospitals in Spain, Italy, Denmark, and Brazil. Eight hundred and eighty-four isolates ( = 534; = 282; and = 68) were genotyped using species-specific microsatellite markers. CDC3, EF3, HIS3, CAI, CAIII, and CAVI were used for , Ctrm1, Ctrm10, Ctrm12, Ctrm21, Ctrm24, and Ctrm28 for , and CP1, CP4a, CP6, and B for . Genotypes were classified as singletons (genotype only found once) or clusters (same genotype infecting two or more patients). Clusters were defined as intra-hospital (involving patients admitted to a single hospital), intra-ward (involving patients admitted to the same hospital ward) or widespread (involving patients admitted to different hospitals). The percentage of clusters and the proportion of patients involved in clusters among species, genotypic diversity and distribution of genetic diversity were assessed. Seven hundred and twenty-three genotypes were detected, 78 (11%) being clusters, most of which (57.7%; = 45/78) were intra-hospital clusters including intra-ward ones (42.2%; = 19/45). The proportion of clusters was not statistically different between species, but the percentage of patients in clusters varied among hospitals. A number of genotypes (7.2%; 52/723) were widespread (found at different hospitals), comprising 66.7% (52/78) of clusters, and involved patients at hospitals in the same city ( = 21) or in different cities ( = 31). Only one cluster was a widespread genotype found in all four countries. Around 11% of and isolates causing candidemia are clusters that may result from patient-to-patient transmission, widespread genotypes commonly found in unrelated patients, or insufficient microsatellite typing genetic discrimination.
本研究的目的是进一步深入了解医院间聚集性分离株的基因型分布和百分比，并识别涉及不同医院和城市的潜在聚集性。我们旨在对西班牙、意大利、丹麦和巴西16家医院收治的患者中引起念珠菌血症的念珠菌属分离株进行基因分型。使用种特异性微卫星标记对884株分离株（白色念珠菌=534株；光滑念珠菌=282株；热带念珠菌=68株）进行基因分型。使用CDC3、EF3、HIS3、CAI、CAIII和CAVI对白色念珠菌进行基因分型，使用Ctrm1、Ctrm10、Ctrm12、Ctrm21、Ctrm24和Ctrm28对光滑念珠菌进行基因分型，使用CP1、CP4a、CP6和B对热带念珠菌进行基因分型。基因型分为单株型（仅发现一次的基因型）或聚集型（同一基因型感染两名或更多患者）。聚集型被定义为医院内（涉及同一医院收治的患者）、病房内（涉及同一医院病房收治的患者）或广泛传播型（涉及不同医院收治的患者）。评估了念珠菌属中聚集型的百分比、聚集型中涉及的患者比例、基因型多样性以及遗传多样性的分布。共检测到723种基因型，其中78种（11%）为聚集型，其中大多数（57.7%；45/78）为医院内聚集型，包括病房内聚集型（42.2%；19/45）。不同念珠菌属之间聚集型的比例无统计学差异，但各医院聚集型患者的百分比有所不同。一些基因型（7.2%；52/723）为广泛传播型（在不同医院发现），占聚集型的66.7%（52/78），涉及同一城市（21例）或不同城市（31例）医院的患者。只有一株白色念珠菌聚集型是在所有四个国家都发现的广泛传播型基因型。引起念珠菌血症的白色念珠菌和光滑念珠菌分离株中约11%为聚集型，可能是患者之间传播、在无关患者中常见的广泛传播型基因型或微卫星分型遗传鉴别不足所致。
