Higgins Paul G, Hagen Ralf Matthias, Kreikemeyer Bernd, Warnke Philipp, Podbielski Andreas, Frickmann Hagen, Loderstädt Ulrike
Institute for Medical Microbiology, Immunology, and Hygiene, University of Cologne, 50935 Cologne, Germany.
German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, 50935 Cologne, Germany.
Antibiotics (Basel). 2021 Mar 11;10(3):291. doi: 10.3390/antibiotics10030291.
At the Bundeswehr Hospitals of Hamburg and Westerstede, patients repatriated from subtropical war and crisis zones of Northern Africa and the Middle East were medically treated, including microbiological assessment. Within a six-year interval, 16 spp. strains, including 14 (Ab) isolates with resistance against carbapenems and origins in Afghanistan ( = 4), Iraq ( = 2), Libya ( = 2), and Syria ( = 8) were collected. While clonal relationships of Libyan and Syrian strains had been assessed by superficial next generation sequencing (NGS) and "DiversiLab" repetitive elements sequence-based (rep-)PCR so far, this study provides core genome-based sequence typing and thus more detailed epidemiological information. In detail, sequencing allowed a definitive species identification and comparison with international outbreak-associated Ab strains by core genome multi locus sequence typing (cgMLST) and the identification of MLST lineages, as well as the identification of known resistance genes. The sequence analysis allowed for the confirmation of outbreak-associated clonal clusters among the Syrian and Afghan Ab isolates, indicating likely transmission events. The identified acquired carbapenem resistance genes comprised , , , and , next to other intrinsic and acquired, partly mobile resistance-associated genes. Eleven out of 14 Ab isolates clustered with the previously described international clonal lineages IC1 (4 Afghan strains), IC2 (6 Syrian strains), and IC7 (1 Syrian strain). Identified Pasteur sequence types of the 14 Ab strains comprised ST2 (Syrian), ST25 (Libyan), ST32 (Iraqi), ST81 (Afghan), ST85 (Libyan), and ST1112 (Syrian), respectively. In conclusion, the study revealed a broad spectrum of resistance genes in Ab isolated from war-injured patients from Northern Africa and the Middle East, thereby broadening the scarcely available data on locally abundant clonal lineages and resistance mechanisms.
在汉堡和韦斯特施泰德的德国联邦国防军医院，对从北非和中东亚热带战争及危机地区遣返的患者进行了医学治疗，包括微生物学评估。在六年的时间间隔内，收集了16种菌株，其中包括14株对碳青霉烯类耐药且来自阿富汗（=4株）、伊拉克（=2株）、利比亚（=2株）和叙利亚（=8株）的鲍曼不动杆菌（Ab）分离株。虽然到目前为止，利比亚和叙利亚菌株的克隆关系已通过表面下一代测序（NGS）和基于“DiversiLab”重复元件序列（rep-）PCR进行了评估，但本研究提供了基于核心基因组的序列分型，从而获得了更详细的流行病学信息。具体而言，测序通过核心基因组多位点序列分型（cgMLST）实现了明确的菌种鉴定，并与国际暴发相关的Ab菌株进行了比较，鉴定了MLST谱系，以及已知的耐药基因。序列分析证实了叙利亚和阿富汗Ab分离株中与暴发相关的克隆簇，表明可能存在传播事件。除了其他固有和获得性、部分可移动的耐药相关基因外，鉴定出的获得性碳青霉烯耐药基因包括 blaOXA-23、blaOXA-24/40、blaNDM-1 和 blaVIM-1。14株Ab分离株中的11株与先前描述的国际克隆谱系IC1（4株阿富汗菌株）、IC2（6株叙利亚菌株）和IC7（1株叙利亚菌株）聚类。14株Ab菌株鉴定出的巴斯德序列类型分别为ST2（叙利亚）、ST25（利比亚）、ST32（伊拉克）、ST81（阿富汗）、ST85（利比亚）和ST1112（叙利亚）。总之，该研究揭示了从北非和中东战争伤员中分离出的Ab中广泛的耐药基因谱，从而拓宽了关于当地丰富的克隆谱系和耐药机制的稀缺数据。
