越南河内三家主要医院耐碳青霉烯类分离株的耐药机制及基因相关性（2011 - 2015年）
Resistance mechanisms and genetic relatedness among carbapenem-resistant isolates from three major hospitals in Hanoi, Vietnam (2011-15).
作者信息
Tran Hai Anh, Vu Thi Ngoc Bich, Trinh Son Tung, Tran Dieu Linh, Pham Ha My, Ngo Thi Hong Hanh, Nguyen Minh Thao, Tran Nhu Duong, Pham Duy Thai, Dang Duc Anh, Shibayama Keigo, Suzuki Masato, Yoshida Lay-Myint, Trinh Hong Son, Le Viet Thanh, Vu Phuong Thom, Luu Thi Vu Nga, Bañuls Anne-Laure, Trinh Khanh Linh, Tran Van Anh, Tran Huy Hoang, van Doorn H Rogier
机构信息
Hanoi Medical University, Hanoi, Vietnam.
Oxford University Clinical Research Unit, Hanoi, Vietnam.
出版信息
JAC Antimicrob Resist. 2021 Jul 27;3(3):dlab103. doi: 10.1093/jacamr/dlab103. eCollection 2021 Sep.
BACKGROUND
MDR bacteria including carbapenem-resistant are recognized as an important cause of hospital-acquired infections worldwide. This investigation seeks to determine the molecular characterization and antibiotic resistance genes associated with carbapenem-resistant .
METHODS
We conducted WGS and phylogenetic analysis of 72 carbapenem-resistant isolated from hospital-acquired infection patients from August 2011 to March 2015 in three major hospitals in Hanoi, Vietnam.
RESULTS
We identified three variants of IMP gene, among which was the most frequent (=34) in comparison to (=2) and (=12). We observed two isolates with imipenem MIC >128 mg/L that co-harboured and genes and seven isolates (imipenem MIC > 128 mg/L) with a gene from the same hospital. MLST data shows that these 72 isolates belong to 18 STs and phylogenetic tree analysis has divided these isolates into nine groups.
CONCLUSIONS
Our results provide evidence that not only but other IMP variants such as and genes and several STs (ST235, ST244, ST277, ST310, ST773 and ST3151) have been disseminating in healthcare settings in Vietnam. In addition, we report the emergence of two isolates belonging to ST1240 and ST3340 that harboured two important carbapenemase genes ( and ) and seven isolates belonging to ST3151 of that carried the gene in Vietnam, which could potentially cause serious restricted availability of treatment options in healthcare settings.
背景
包括耐碳青霉烯类在内的多重耐药菌被认为是全球医院获得性感染的重要原因。本研究旨在确定与耐碳青霉烯类相关的分子特征和抗生素耐药基因。
方法
我们对2011年8月至2015年3月期间从越南河内三家主要医院的医院获得性感染患者中分离出的72株耐碳青霉烯类进行了全基因组测序（WGS）和系统发育分析。
结果
我们鉴定出IMP基因的三种变体，其中IMP-4是最常见的（=34），而IMP-1（=2）和IMP-2（=12）相对较少。我们观察到两株亚胺培南最低抑菌浓度（MIC）>128mg/L的菌株同时携带blaVIM和blaIMP基因，以及来自同一家医院的七株携带blaNDM基因（亚胺培南MIC>128mg/L）的菌株。多位点序列分型（MLST）数据显示，这72株菌株属于18个序列型（ST），系统发育树分析将这些菌株分为九组。
结论
我们的结果表明，不仅blaNDM，其他IMP变体如blaVIM和blaIMP基因以及几个序列型（ST235、ST244、ST277、ST310、ST773和ST3151）已在越南的医疗机构中传播。此外，我们报告了在越南出现了两株属于ST1240和ST3340且携带两种重要碳青霉烯酶基因（blaVIM和blaIMP）的菌株，以及七株属于ST3151且携带blaNDM基因的菌株，这可能会导致医疗机构中治疗选择的严重受限。
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