Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania.
Microb Drug Resist. 2022 Jun;28(6):636-644. doi: 10.1089/mdr.2021.0274. Epub 2022 May 18.
can cause difficult-to-treat infections because it can acquire extensive antimicrobial resistance mechanisms. We aim to describe the antimicrobial resistance pattern and the genetic basis of carbapenem-nonsusceptible isolates in a University Hospital in Romania, a country where multidrug-resistant is widespread. We collected 104 consecutive meropenem-nonsusceptible isolates from 104 patients (36% female, mean age [SD] of 63 [16] years) between May 2015 and August 2017 from a large tertiary center in Romania. Whole-genome sequencing of representative isolates from amplified fragment length polymorphism clusters was used to determine clonality and resistance patterns. All isolates were resistant to piperacillin/tazobactam, ceftazidime, and ciprofloxacin; 88.5% to gentamicin; and 90.4% to trimethoprim/sulfamethoxazole. In contrast, 79.8% and 99.0% were susceptible to tobramycin and colistin, respectively. The only isolate resistant to colistin had an minimum inhibitory concentration (MIC) of ≥16 mg/L. The gene was detected in 79.1% and in 20.9% of the isolates. In one isolate, was copresent with . ST502 (Oxford scheme) was the most prevalent sequence type and was exclusively associated with . ST502 associated with was frequently observed in the region where carbapenem-nonsusceptible was found to be endemic. In these isolates, tobramycin and colistin might be the remaining therapeutic options. Due to differences in gentamicin and tobramycin resistance in these isolates, surveillance data should not group gentamicin, tobramycin, and amikacin together as aminoglycosides.
可导致治疗困难的感染，因为它可以获得广泛的抗菌药物耐药机制。我们旨在描述罗马尼亚一所大学医院中耐碳青霉烯类 分离株的抗菌药物耐药模式和遗传基础，该国广泛存在多重耐药 。我们收集了 2015 年 5 月至 2017 年 8 月期间来自罗马尼亚一家大型三级中心的 104 例连续耐美罗培南 分离株（36%为女性，平均年龄 [标准差] 63 [16] 岁）。对扩增片段长度多态性聚类中代表性分离株的全基因组测序用于确定克隆性和耐药模式。所有分离株均对哌拉西林/他唑巴坦、头孢他啶和环丙沙星耐药；88.5%对庆大霉素耐药；90.4%对甲氧苄啶/磺胺甲恶唑耐药。相比之下，分别有 79.8%和 99.0%的分离株对妥布霉素和黏菌素敏感。唯一对黏菌素耐药的分离株的最低抑菌浓度（MIC）≥16mg/L。 基因在 79.1%和 20.9%的分离株中被检测到。在一个分离株中， 与 同时存在。Oxford 方案的 ST502 是最常见的序列类型，仅与 相关。ST502 与 相关的分离株在发现耐碳青霉烯类 流行的地区经常被观察到。在这些分离株中，妥布霉素和黏菌素可能是剩余的治疗选择。由于这些分离株中庆大霉素和妥布霉素耐药性的差异，监测数据不应将庆大霉素、妥布霉素和阿米卡星归为氨基糖苷类药物。
