Huang Yu-Shan, Lai Liang-Chuan, Chen Yu-An, Lin Kuan-Yin, Chou Yi-Hsuan, Chen Hsiu-Chi, Wang Shu-Sheng, Wang Jann-Tay, Chang Shan-Chwen
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Front Microbiol. 2020 Jun 24;11:1402. doi: 10.3389/fmicb.2020.01402. eCollection 2020.
The prevalence of colonization with multidrug-resistant organisms (MDROs) among healthy adults in the community is largely unknown. This study investigated the colonization rate of multidrug-resistant , methicillin-resistant (MRSA), and vancomycin-resistant enterococci (VRE) in the community in Taiwan, and compared the gut microbiota between MDRO carriers and non-carriers.
This prospective cohort study was conducted from March 2017 to February 2018 at the Hsin-Chu and Jin-Shan branches of National Taiwan University Hospital. Nasal swabs and stool samples were obtained from healthy adults attending a health examination to screen for MDROs. Bacteria isolates of MDROs were tested for antibiotic susceptibility and resistant genes. Relevant data were collected using a standardized questionnaire to evaluate the risk factors for MDROs carriage, and 16S rRNA metagenomics sequencing was performed to analyze gut microbiota.
Among 187 participants, 4.6% (8/174) carried MRSA and 41.4% (77/186) carried third-generation cephalosporin-resistant (3GC-R) or . The carriage rate of AmpC beta-lactamases and ESBL-producing strains were 16.1 and 27.4%, respectively. No carbapenem-resistant (CRE) or VRE were detected. The dominant resistant gene of isolates was CTX-M-type (73%), while that of was AmpC beta-lactamases (80%). In the multivariate analysis, the significant risk factors for carrying 3GC-R or were being an employee of technology company A [adjusted odds ratio (aOR) 4.127; 95% confidence interval (CI) 1.824-9.336; = 0.001], and traveling to Southeast Asia in the past year (aOR 6.545; 95% CI 1.071-40.001; = 0.042). The gut microbiota analysis showed that the phylum and the family were significantly more abundant in 3GC-R and carriers.
A high rate of Taiwanese adults in the community carried 3GC-R , while no CRE or VRE colonization was noted. Compared with non-carriers, an expansion of in gut microbiota was found among 3GC-R carriers.
社区中健康成年人多重耐药菌（MDROs）的定植率在很大程度上尚不清楚。本研究调查了台湾社区中多重耐药菌、耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素肠球菌（VRE）的定植率，并比较了MDRO携带者和非携带者之间的肠道微生物群。
本前瞻性队列研究于2017年3月至2018年2月在台湾大学医院新竹分院和金山分院进行。从参加健康检查的健康成年人中采集鼻拭子和粪便样本，以筛查MDROs。对MDROs的细菌分离株进行抗生素敏感性和耐药基因检测。使用标准化问卷收集相关数据，以评估MDROs携带的危险因素，并进行16S rRNA宏基因组测序以分析肠道微生物群。
在187名参与者中，4.6%（8/174）携带MRSA，41.4%（77/186）携带对第三代头孢菌素耐药（3GC-R）的肠杆菌科细菌或肺炎克雷伯菌。产AmpCβ-内酰胺酶菌株和产超广谱β-内酰胺酶（ESBL）菌株的携带率分别为16.1%和27.4%。未检测到耐碳青霉烯类肠杆菌科细菌（CRE）或VRE。肠杆菌科细菌分离株的主要耐药基因是CTX-M型（73%），而肺炎克雷伯菌的主要耐药基因是AmpCβ-内酰胺酶（80%）。在多变量分析中，携带3GC-R肠杆菌科细菌或肺炎克雷伯菌的显著危险因素是为科技公司A的员工[调整优势比（aOR）4.127；95%置信区间（CI）1.824-9.336；P = 0.001]，以及过去一年去过东南亚（aOR 6.545；95%CI 1.071-40.001；P = 0.042）。肠道微生物群分析显示，3GC-R肠杆菌科细菌和肺炎克雷伯菌携带者中厚壁菌门和毛螺菌科的丰度显著更高。
台湾社区中成年人群体携带3GC-R肠杆菌科细菌的比例较高，未发现CRE或VRE定植。与非携带者相比，3GC-R肠杆菌科细菌携带者的肠道微生物群中厚壁菌门有所扩张。
