Mancilla-Rojano Jetsi, Ochoa Sara A, Reyes-Grajeda Juan Pablo, Flores Víctor, Medina-Contreras Oscar, Espinosa-Mazariego Karina, Parra-Ortega Israel, Rosa-Zamboni Daniela De La, Castellanos-Cruz María Del Carmen, Arellano-Galindo José, Cevallos Miguel A, Hernández-Castro Rigoberto, Xicohtencatl-Cortes Juan, Cruz-Córdova Ariadnna
Laboratorio de Investigación en Bacteriología Intestinal, Subdirección de Gestión de la Investigación, Hospital Infantil de México Federico Gómez, CDMX, Mexico.
Facultad de Medicina, Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, CDMX, Mexico.
Front Microbiol. 2020 Oct 15;11:576673. doi: 10.3389/fmicb.2020.576673. eCollection 2020.
The - () complex is regarded as a group of phenotypically indistinguishable opportunistic pathogens responsible for mainly causing hospital-acquired pneumonia and bacteremia. The aim of this study was to determine the frequency of isolation of the species that constitute the complex, as well as their susceptibility to antibiotics, and their distribution at the Hospital Infantil de Mexico Federico Gomez (HIMFG). A total of 88 strains previously identified by Vitek 2®, 40 as and 48 as complex were isolated from 52 children from 07, January 2015 to 28, September 2017. accounted for 89.77% (79/88) of the strains; , 6.82% (6/88); and , 3.40% (3/88). Most strains were recovered mainly from patients in the intensive care unit (ICU) and emergency wards. Blood cultures (BC) provided 44.32% (39/88) of strains. The 13.63% (12/88) of strains were associated with primary bacteremia, 3.4% (3/88) with secondary bacteremia, and 2.3% (2/88) with pneumonia. In addition, 44.32% (39/88) were multidrug-resistant (MDR) strains and, 11.36% (10/88) were extensively drug-resistant (XDR). All strains amplified the gene; 51.13% (45/88), the gene; 4.54% (4/88), the gene; and 2.27% (2/88), the gene. Plasmid profiles showed that the strains had 1-6 plasmids. The strains were distributed in 52 pulsotypes, and 24 showed identical restriction patterns, with a correlation coefficient of 1.0. Notably, some strains with the same pulsotype were isolated from different patients, wards, or years, suggesting the persistence of more than one clone. Twenty-seven sequence types (STs) were determined for the strains based on a Pasteur multilocus sequence typing (MLST) scheme using massive sequencing; the most prevalent was ST 156 (27.27%, 24/88). The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)-Cas I-Fb system provided amplification in and strains (22.73%, 20/88). This study identified an increased number of MDR strains and the relationship among strains through molecular typing. The data suggest that more than one strain could be causing an infection in some patient. The implementation of molecular epidemiology allowed the characterization of a set of strains and identification of different attributes associated with its distribution in a specific environment.
-()复合体被视为一组表型无法区分的机会致病菌,主要导致医院获得性肺炎和菌血症。本研究的目的是确定构成该复合体的菌种的分离频率、它们对抗生素的敏感性以及在墨西哥费德里科·戈麦斯儿童医院(HIMFG)的分布情况。2015年1月7日至2017年9月28日期间,从52名儿童中分离出88株先前经Vitek 2®鉴定的菌株,其中40株为,48株为复合体。占菌株的89.77%(79/88);,6.82%(6/88);,3.40%(3/88)。大多数菌株主要从重症监护病房(ICU)和急诊病房的患者中分离得到。血培养(BC)提供了44.32%(39/88)的菌株。13.63%(12/88)的菌株与原发性菌血症相关,3.4%(3/88)与继发性菌血症相关,2.3%(2/88)与肺炎相关。此外,44.32%(39/88)为多重耐药(MDR)菌株,11.36%(10/88)为广泛耐药(XDR)菌株。所有菌株均扩增了基因;51.13%(45/88),基因;4.54%(4/88),基因;2.27%(2/88),基因。质粒图谱显示菌株有1 - 6个质粒。菌株分布在52个脉冲型中,24个显示相同的限制性模式,相关系数为1.0。值得注意的是,一些具有相同脉冲型的菌株从不同患者、病房或年份中分离得到,这表明存在不止一个克隆的持续性。基于巴斯德多位点序列分型(MLST)方案,通过大规模测序为菌株确定了27种序列类型(STs);最常见的是ST 156(27.27%,24/88)。成簇规律间隔短回文重复序列(CRISPR)-Cas I-Fb系统在和菌株中提供了扩增(22.73%,20/88)。本研究通过分子分型鉴定出数量增加的MDR菌株以及菌株之间的关系。数据表明在一些患者中可能有不止一种菌株导致感染。分子流行病学的实施使得能够对一组菌株进行特征描述,并识别与其在特定环境中分布相关的不同属性。
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