介导的利奈唑胺耐药性的出现：2014 - 2018年中国西南部一家三级医院的分子调查
Emergence of Mediated Linezolid Resistance in : A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014-2018.
作者信息
Yi Miao, Zou Jiaqi, Zhao Jinxin, Tang Yu, Yuan Yaling, Yang Bingxue, Huang Jinzhu, Xia Peiwen, Xia Yun
机构信息
Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.
出版信息
Infect Drug Resist. 2022 Jan 4;15:13-20. doi: 10.2147/IDR.S339761. eCollection 2022.
PURPOSE
To investigate the potential mechanism and molecular characteristics of linezolid-non-sensitive from a tertiary hospital in southwest China and characterize the relevant plasmids.
PATIENTS AND METHODS
Linezolid-non-sensitive (LNSEFM) isolates collected from January 2014 to December 2018 were screened for resistant genes , by PCR. Molecular epidemiological analysis was performed by multilocus sequence typing (MLST). The -and- co-harboring strain was subjected to the whole genome sequencing (WGS) by Illumina HiSeq and Oxford Nanopore MinION.
RESULTS
A total of 15 LNSEFM with linezolid MICs ranging from 4 to 16 mg/L were identified. About 66.7% (10/15) of isolates were linezolid-resistant. About 46.7% (7/15) of strains were positive for . Two types of variants (P and EYDNDM) were identified. About 13.3% (2/15) of isolates had . 1 harbored a L22 protein alteration (Ser77Thr). One isolate coharbored (EYDNDM variant) and . There was no mutation in the gene that encoded the ribosomal protein / or the domain V of 23S rRNA. No gene was detected. Based on WGS data, was associated with Tn558 inserted to gene and was flanked by IS1216E.
CONCLUSION
is primary mechanism in linezolid-resistant . This is the first report of variants P and EYDNDM identified in and -and- co-harboring clinically in southwest China. Besides, Tn558 and IS1216Es may play an important role in the dissemination of and , respectively. The findings revealed the potential threat to nosocomial infection by and coexistence of and in . Thus, clinical surveillance of linezolid-resistant is urgently needed.
目的
探讨中国西南地区一家三级医院耐利奈唑胺菌株的潜在机制和分子特征，并对相关质粒进行表征。
患者与方法
对2014年1月至2018年12月收集的耐利奈唑胺菌株（LNSEFM）进行PCR筛选耐药基因。通过多位点序列分型（MLST）进行分子流行病学分析。对同时携带erm(B)和cfr的菌株采用Illumina HiSeq和Oxford Nanopore MinION进行全基因组测序（WGS）。
结果
共鉴定出15株耐利奈唑胺菌株，其利奈唑胺MIC值为4至16mg/L。约66.7%（10/15）的分离株对利奈唑胺耐药。约46.7%（7/15）的菌株erm(B)呈阳性。鉴定出两种erm(B)变体（P和EYDNDM）。约13.3%（2/15）的分离株携带cfr。1株携带L22蛋白改变（Ser77Thr）。1株同时携带erm(B)（EYDNDM变体）和cfr。编码核糖体蛋白L3或23S rRNA结构域V的基因未发生突变。未检测到optrA基因。基于WGS数据，erm(B)与插入23S rRNA基因的Tn558相关，cfr侧翼为IS1216E。
结论
erm(B)是耐利奈唑胺肠球菌的主要耐药机制。这是中国西南地区临床首次报道在肠球菌中鉴定出erm(B)变体P和EYDNDM以及同时携带erm(B)和cfr。此外，Tn558和IS1216E可能分别在erm(B)和cfr的传播中起重要作用。研究结果揭示了肠球菌中erm(B)和cfr共存对医院感染的潜在威胁。因此，迫切需要对耐利奈唑胺肠球菌进行临床监测。
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