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ST11-K47型耐碳青霉烯类高毒力菌株致肝脓肿的临床与分子分析

Clinical and Molecular Analysis of ST11-K47 Carbapenem-Resistant Hypervirulent : A Strain Causing Liver Abscess.

作者信息

Cai Zhen, Jia Tianye, Pu Mingfang, Zhang Shuyong, Zhang Jingxia, Geng Ronghua, Chen Suming, Li Yahao, Fan Huahao, Tong Yigang, Qu Fen

机构信息

Aviation General Hospital, Beijing 100012, China.

The Clinical Laboratory, Fifth Medical Center of PLA General Hospital, Beijing 100039, China.

出版信息

Pathogens. 2022 Jun 7;11(6):657. doi: 10.3390/pathogens11060657.

Abstract

has been the predominant pathogen of liver abscess, but ST11-K47 carbapenem-resistant hypervirulent (CR-hvKP) has rarely been studied as the causative organism. We identified an ST11-K47 CR-hvKP (HvKp-su1) from the drainage fluid of a liver abscess in a Chinese man who was diagnosed with liver abscess combined with diabetes, pneumonia, pleural infection, abdominal abscess, and splenic abscess. HvKp-su1 was non-hypermucoviscous and lacked the and genes and pLVPK plasmid but exhibited high virulence, with a high mortality rate (90%) to wax moth larvae (), similar to the hypervirulent ATCC43816 (91.67%). Whole-genome sequencing and bioinformatics analysis indicated that HvKp-su1 possesses a plasmid similar to a type of pLVPK-like plasmid (JX-CR-hvKP-2-P2), which is an uncommon plasmid in CR-hvKP. HvKp-su1 carried multiple resistance genes, including . , , and ; hypervirulence genes such as aerobactin (), salmochelin (), and yersiniabactin (); and the type 3 fimbriae-encoding system (). Moreover, v_5377 and v_5429 ( CFA/III (CS8)) located on plasmid 1 were simultaneously predicted to be virulence genes. After the long-term combination use of antibiotics, the patient successfully recovered. In summary, our study clarified the clinical and molecular characteristics of a rare ST11-K47 CR-hvKP (HvKp-su1), raising great concerns about the emergence of ST11-K47 CR-hvKP with multidrug resistance and hypervirulence, and providing insights into the control and treatment of liver abscess caused by ST11-K47 CR-hvKP.

摘要

一直是肝脓肿的主要病原体,但作为致病生物体,ST11-K47碳青霉烯耐药高毒力(CR-hvKP)很少被研究。我们从一名被诊断为肝脓肿合并糖尿病、肺炎、胸膜感染、腹腔脓肿和脾脓肿的中国男性患者的肝脓肿引流液中鉴定出一株ST11-K47 CR-hvKP(HvKp-su1)。HvKp-su1无高黏液性,缺乏 和 基因以及pLVPK质粒,但具有高毒力,对大蜡螟幼虫的死亡率很高(90%),与高毒力的 ATCC43816(91.67%)相似。全基因组测序和生物信息学分析表明,HvKp-su1拥有一种类似于pLVPK样质粒(JX-CR-hvKP-2-P2)的质粒,这在CR-hvKP中是一种不常见的质粒。HvKp-su1携带多个耐药基因,包括. 、 、 和 ;高毒力基因,如气杆菌素( )、沙门菌素( )和耶尔森菌素( );以及3型菌毛编码系统( )。此外,位于质粒1上的v_5377和v_5429(CFA/III(CS8))同时被预测为毒力基因。经过长期联合使用抗生素后,患者成功康复。总之,我们的研究阐明了一种罕见的ST11-K47 CR-hvKP(HvKp-su1)的临床和分子特征,引发了对具有多重耐药性和高毒力的ST11-K47 CR-hvKP出现的高度关注,并为ST11-K47 CR-hvKP引起的肝脓肿的控制和治疗提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f2/9227846/f281acedaf62/pathogens-11-00657-g001.jpg

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