Department of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Microbiology & Immunology, Indiana University School of Medicine-Northwest, Gary, Indiana, USA.
Environ Microbiol. 2022 Mar;24(3):1518-1542. doi: 10.1111/1462-2920.15930. Epub 2022 Mar 19.
Gram-negative bacteria (GNB) continue to develop resistance against important antibiotics including last-resort ones such as carbapenems and polymyxins. An analysis of GNB with co-resistance to carbapenems and polymyxins from a One Health perspective is presented. Data of species name, country, source of isolation, resistance genes (ARGs), plasmid type, clones and mobile genetic elements (MGEs) were deduced from 129 articles from January 2016 to March 2021. Available genomes and plasmids were obtained from PATRIC and NCBI. Resistomes and methylomes were analysed using BAcWGSTdb and REBASE whilst Kaptive was used to predict capsule typing. Plasmids and other MEGs were identified using MGE Finder and ResFinder. Phylogenetic analyses were done using RAxML and annotated with MEGA 7. A total of 877 isolates, 32 genomes and 44 plasmid sequences were analysed. Most of these isolates were reported in Asian countries and were isolated from clinical, animal and environmental sources. Colistin resistance was mostly mediated by mgrB inactivation (37%; n = 322) and mcr-1 (36%; n = 312), while OXA-48/181 was the most reported carbapenemase. IncX and IncI were the most common plasmids hosting carbapenemases and mcr genes. The isolates were co-resistant to other antibiotics, with floR (chloramphenicol) and fosA3 (fosfomycin) being common; E. coli ST156 and K. pneumoniae ST258 strains were common globally. Virulence genes and capsular KL-types were also detected. Type I, II, III and IV restriction modification systems were detected, comprising various MTases and restriction enzymes. The escalation of highly resistant isolates drains the economy due to untreatable bacterial infections, which leads to increasing global mortality rates and healthcare costs.
革兰氏阴性菌（GNB）继续对包括碳青霉烯类和多黏菌素类等最后手段抗生素产生耐药性。从“同一健康”角度分析了对碳青霉烯类和多黏菌素类同时具有耐药性的 GNB。从 2016 年 1 月至 2021 年 3 月，从 129 篇文章中推断出物种名称、国家、分离源、耐药基因（ARGs）、质粒类型、克隆和移动遗传元件（MGEs）的数据。可利用的基因组和质粒从 PATRIC 和 NCBI 获得。使用 BAcWGSTdb 和 REBASE 分析抗药组和甲基组，使用 Kaptive 预测荚膜分型。使用 MGE Finder 和 ResFinder 鉴定质粒和其他 MEG。使用 RAxML 进行系统发育分析，并使用 MEGA 7 进行注释。共分析了 877 株分离株、32 个基因组和 44 个质粒序列。这些分离株大多在亚洲国家报告，从临床、动物和环境来源中分离。粘菌素耐药主要由 mgrB 失活（37%；n=322）和 mcr-1（36%；n=312）介导，而 OXA-48/181 是最常见的碳青霉烯酶。IncX 和 IncI 是携带碳青霉烯酶和 mcr 基因的最常见质粒。这些分离株对其他抗生素具有协同耐药性，其中 floR（氯霉素）和 fosA3（磷霉素）较为常见；E. coli ST156 和 K. pneumoniae ST258 菌株在全球范围内较为常见。还检测到毒力基因和荚膜 KL 型。检测到 I、II、III 和 IV 型限制修饰系统，包括各种 MTases 和限制酶。由于无法治疗的细菌感染，高度耐药的分离株不断增加，导致经济负担加重，全球死亡率和医疗保健成本不断上升。
