从意大利一家囊性纤维化中心的患者中分离出的脓肿分枝杆菌亚种的分子特征。
Molecular characterization of Mycobacterium abscessus subspecies isolated from patients attending an Italian Cystic Fibrosis Centre.
作者信息
Teri Antonio, Sottotetti Samantha, Arghittu Milena, Girelli Daniela, Biffi Arianna, D'Accico Monica, Daccò Valeria, Gambazza Simone, Pizzamiglio Giovanna, Trovato Alberto, Tortoli Enrico, Colombo Carla, Cariani Lisa
机构信息
UOS Microbiology and Cystic Fibrosis Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
出版信息
New Microbiol. 2020 Jul;43(3):127-132. Epub 2020 Jun 13.
Mycobacterium abscessus (MABS) infection represents significant management challenge in cystic fibrosis (CF) patients. This retrospective study (2005-2016) aims to determine the prevalence of the subspecies of MABS isolated from CF patients, to evaluate the persistence over the years of a single subspecies of MABS and to correlate mutations responsible for macrolides and amikacin resistance with MIC values. We investigated 314 strains (1 isolate/patient/year) isolated from the lower respiratory tract of 51 chronically infected CF patients. Sequencing of rpoB gene was performed to identify the MABS subspecies. The erm(41) gene was sequenced to differentiate the strains with and without inducible macrolide resistance. Regions of 23S and 16S rRNA were sequenced to investigate mutations responsible for constitutive resistance to macrolides and aminoglycosides, respectively. Antibiotic susceptibility, using commercial microdilution plates, was evaluated according to CLSI. M. abscessus subsp. abscessus accounted for 64% of the isolates, bolletii subspecies for 16% and massiliense subspecies for 20%. All the massiliense strains presented truncated erm(41) gene while 12 abscessus strains presented the mutation T28->C in the erm(41) gene, which makes it inactive. The 23S rRNA analysis did not show constitutive resistance to macrolides in any strain. Mutation of the 16S rRNA gene was highlighted in 2 strains out of 314, in agreement with high MIC values. The correct identification at the subspecies level and the molecular analysis of 23S rRNA, 16S rRNA and erm gene is useful to guide the treatment strategy in patients with M. abscessus lung infection.
脓肿分枝杆菌(MABS)感染是囊性纤维化(CF)患者治疗面临的重大挑战。这项回顾性研究(2005 - 2016年)旨在确定从CF患者中分离出的MABS亚种的流行情况,评估单一MABS亚种多年来的持续性,并将导致大环内酯类和阿米卡星耐药的突变与最低抑菌浓度(MIC)值相关联。我们调查了从51例慢性感染CF患者下呼吸道分离出的314株菌株(每年1株/患者)。进行rpoB基因测序以鉴定MABS亚种。对erm(41)基因进行测序以区分具有和不具有诱导性大环内酯耐药性的菌株。分别对23S和16S rRNA区域进行测序,以研究导致对大环内酯类和氨基糖苷类药物固有耐药性的突变。使用商业微量稀释板,根据临床和实验室标准协会(CLSI)评估抗生素敏感性。脓肿分枝杆菌脓肿亚种占分离株的64%,博勒蒂亚种占16%,马赛亚种占20%。所有马赛菌株均呈现erm(41)基因截短,而12株脓肿菌株在erm(41)基因中出现T28→C突变,使其失活。23S rRNA分析未显示任何菌株对大环内酯类药物具有固有耐药性。在314株菌株中有2株突出显示了16S rRNA基因突变,这与高MIC值一致。在亚种水平上的正确鉴定以及对23S rRNA、16S rRNA和erm基因的分子分析有助于指导脓肿分枝杆菌肺部感染患者的治疗策略。