Agosta Marilena, Bencardino Daniela, Argentieri Marta, Pansani Laura, Sisto Annamaria, Ciofi Degli Atti Marta Luisa, D'Amore Carmen, Putignani Lorenza, Bagolan Pietro, Iacobelli Barbara Daniela, Dotta Andrea, Martini Ludovica, Di Chiara Luca, Magnani Mauro, Perno Carlo Federico, Andreoni Francesca, Bernaschi Paola
Microbiology and Diagnostic Immunology Unit, Department of Diagnostic and Laboratory Medicine, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Department of Biomolecular Sciences, University of Urbino "Carlo Bo", 61032 Fano, Italy.
Antibiotics (Basel). 2022 Mar 23;11(4):431. doi: 10.3390/antibiotics11040431.
The spread of carbapenemase-producing Enterobacterales (CPE), especially () and (), is a serious public health threat in pediatric hospitals. The associated risk in newborns is due to their underdeveloped immune system and limited treatment options. The aim was to estimate the prevalence and circulation of CPE among the neonatal intensive units of a major pediatric hospital in Italy and to investigate their molecular features. A total of 124 CPE were isolated from rectal swabs of 99 newborn patients at Bambino Gesù Children's Hospital between July 2016 and December 2019. All strains were characterized by antimicrobial susceptibility testing, detection of resistance genes, and PCR-based replicon typing (PBRT). One strain for each PBRT profile of or was characterized by multilocus-sequence typing (MLST). Interestingly, the majority of strains were multidrug-resistant and carried the gene. A large part was characterized by a multireplicon status, and FII, A/C, FIA (15%) was the predominant. Despite the limited size of collection, MLST analysis revealed a high number of Sequence Types (STs): 14 STs among 28 and 8 STs among 11 , with the prevalence of the well-known clones ST307 and ST131, respectively. This issue indicated that some strains shared the same circulating clone. We identified a novel, so far never described, ST named ST10555, found in one strain. Our investigation showed a high heterogeneity of CPE circulating among neonatal units, confirming the need to monitor their dissemination in the hospital also through molecular methods.
产碳青霉烯酶肠杆菌科细菌（CPE）的传播，尤其是（）和（），对儿科医院的公共卫生构成了严重威胁。新生儿面临的相关风险是由于其免疫系统发育不完善以及治疗选择有限。本研究旨在评估意大利一家大型儿科医院新生儿重症监护病房中CPE的流行情况和传播情况，并调查其分子特征。2016年7月至2019年12月期间，在 Bambino Gesù儿童医院从99名新生儿患者的直肠拭子中总共分离出124株CPE。所有菌株均通过抗菌药物敏感性测试、耐药基因检测和基于PCR的复制子分型（PBRT）进行鉴定。对每种（）或（）PBRT图谱的一株菌株进行多位点序列分型（MLST）。有趣的是，大多数菌株具有多重耐药性并携带（）基因。很大一部分菌株具有多复制子状态，FII、A/C、FIA（15%）是主要类型。尽管样本量有限，但MLST分析显示出大量的序列类型（STs）：28株（）中有14种STs，11株（）中有8种STs，分别以知名克隆ST307和ST131为主。这表明一些菌株共享相同的流行克隆。我们在一株（）菌株中鉴定出一种新的、迄今为止从未描述过的ST，命名为ST10555。我们的调查显示新生儿病房中CPE的传播具有高度异质性，这证实了还需要通过分子方法监测它们在医院中的传播情况。
