GRAM 2.0, Normandie Univ, UNIROUEN, UNICAEN, 76000, Rouen, France.
GRAM 2.0, CHU Rouen, Department of Microbiology, Normandie Univ, UNIROUEN, UNICAEN, 76000, Rouen, France.
Sci Rep. 2022 Mar 30;12(1):5421. doi: 10.1038/s41598-022-09234-5.
This study aimed to assess phenotypic and molecular inter-patient and within-host diversity of Pseudomonas aeruginosa isolates responsible for urinary tract infection (UTI) or asymptomatic bacteriuria (AB). Clinical data of 120 consecutive P. aeruginosa UTI (n = 40) and AB (n = 80) were prospectively analyzed. Up to five P. aeruginosa isolates per sample were collected. Antimicrobial susceptibility testing (AST) was determined for all isolates (n = 591); a subset of 358 was characterized by multilocus sequence typing. 444 isolates (75%) were non-multidrug resistant (MDR), 113 (19%) were MDR, and 34 (6%) were extensively drug resistant. A genetically highly diverse population was observed (64 sequence types [STs]), without strict correlation between genotypes and clinical settings. 35 patients (28%; 12 UTIs and 23 ABs) presented distinct antimicrobial resistance (AMR) profiles within a given urine sample, significantly associated with previous carbapenem and fluroquinolones exposure; five of them also exhibited polyclonal UTI or AB (with isolates belonging to two STs). P. aeruginosa urinary isolates of these 120 patients were highly diverse, in terms of AMR as well as genetic background. Both within-host AMR and molecular diversity can complicate AST, treatment and control of P. aeruginosa UTI.
本研究旨在评估引起尿路感染（UTI）或无症状菌尿（AB）的铜绿假单胞菌分离株的表型和分子种内和种间多样性。前瞻性分析了 120 例连续的铜绿假单胞菌 UTI（n=40）和 AB（n=80）患者的临床数据。从每个样本中采集了多达 5 个铜绿假单胞菌分离株。对所有分离株（n=591）进行了药敏试验（AST）；对 358 个分离株进行了多位点序列分型特征分析。444 株（75%）为非多药耐药（MDR），113 株（19%）为 MDR，34 株（6%）为广泛耐药。观察到遗传上高度多样化的种群（64 个序列型[ST]），基因型与临床环境之间没有严格的相关性。35 名患者（28%，12 例 UTI 和 23 例 AB）在同一尿液样本中表现出不同的抗生素耐药（AMR）谱，与先前的碳青霉烯类和氟喹诺酮类药物暴露显著相关；其中 5 例还表现出多克隆 UTI 或 AB（分离株属于 2 个 ST）。这 120 例患者的铜绿假单胞菌尿分离株在 AMR 和遗传背景方面均具有高度多样性。种内 AMR 和分子多样性均可使 AST 复杂化，从而影响铜绿假单胞菌 UTI 的治疗和控制。
