Chen Tao, Fu Ying, Hua Xiaoting, Xu Qingye, Lan Peng, Jiang Yan, Yu Yunsong, Zhou Zhihui
Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine Zhejiang University, Hangzhou, China; and Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China.
Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine Zhejiang University, Hangzhou, China; and Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China.
Int J Antimicrob Agents. 2021 Oct;58(4):106404. doi: 10.1016/j.ijantimicag.2021.106404. Epub 2021 Jul 21.
A total of 54 unique clinical Acinetobacter baumannii strains isolated from cerebrospinal fluid (CSF) together with 21 bloodstream isolates collected from five tertiary hospitals in East China between April 2013 and November 2016 were studied for antimicrobial susceptibility patterns and the prevalence of antimicrobial resistance genes. Molecular epidemiological characteristics of CSF isolates and the phylogenetic relationship of isolates from different sources were assessed using multilocus sequence typing (MLST) and core genome MLST (cgMLST). Of the 54 CSF isolates, 51 (94.4%) were bla-carrying carbapenem-resistant A. baumannii. Their average resistance rate to different classes of antibiotics was extremely high (>90%), except for tigecycline and colistin. According to the Oxford MLST scheme, all CSF isolates fell into 10 defined sequence types (STs) and 4 novel STs. ST195 and ST208 were the leading STs in isolates from either source. A total of 50 CSF isolates and 20 bloodstream isolates were assigned to clonal complex 92 (CC92), revealing a wild distribution of CC92 in the hospitals of East China. In combination with epidemiological data linked in time and space, cgMLST results elucidated intrahospital and interhospital polyclonal dissemination of A. baumannii causing meningitis. Based on cgMLST, there was no correlation between phylogeny and the source of isolation of A. baumannii. These results emphasise that the genetic potential of this pathogen is vast enough to infect multiple human body sites.
2013年4月至2016年11月期间，从中国东部五家三级医院收集了54株从脑脊液（CSF）中分离出的独特临床鲍曼不动杆菌菌株以及21株血液分离株，对其进行了药敏模式和耐药基因流行情况研究。使用多位点序列分型（MLST）和核心基因组MLST（cgMLST）评估脑脊液分离株的分子流行病学特征以及不同来源分离株的系统发育关系。在54株脑脊液分离株中，51株（94.4%）为携带bla的耐碳青霉烯鲍曼不动杆菌。除替加环素和黏菌素外，它们对不同种类抗生素的平均耐药率极高（>90%）。根据牛津MLST方案，所有脑脊液分离株分为10种确定的序列类型（STs）和4种新的STs。ST195和ST208是两种来源分离株中的主要STs。共有50株脑脊液分离株和20株血液分离株被归入克隆复合体92（CC92），表明CC92在中国东部医院中广泛分布。结合时间和空间上的流行病学数据，cgMLST结果阐明了引起脑膜炎的鲍曼不动杆菌在医院内和医院间的多克隆传播。基于cgMLST，鲍曼不动杆菌的系统发育与分离来源之间没有相关性。这些结果强调，这种病原体的遗传潜能足以感染人体的多个部位。
