Yamba Kaunda, Kapesa Christine, Mpabalwani Evans, Hachaambwa Lottie, Smith Anthony Marius, Young Andrea Liezl, Gally David, Mainda Geoffrey, Mukuma Mercy, Samutela Mulemba Tillika, Kalonda Annie, Mwansa James, Muma John Bwalya
University Teaching Hospitals, Pathology and Microbiology Laboratory, Lusaka, Zambia.
University of Zambia, School of Veterinary Medicine, Department of Disease Control, Lusaka, Zambia.
IJID Reg. 2022 Apr 25;3:248-255. doi: 10.1016/j.ijregi.2022.04.003. eCollection 2022 Jun.
This study investigated antimicrobial susceptibility and genomic profiling of isolated from bloodstream infections at a tertiary referral hospital in Lusaka, Zambia, 2018-2019.
This was a prospective hospital-based study involving routine blood culture samples submitted to the microbiology laboratory at the University Teaching Hospital. Identification of and determination of antimicrobial susceptibility profiles was achieved through conventional and automated methods. Whole-genome sequencing (WGS) was conducted, and the sequence data outputs were processed for species identification, serotype determination, multilocus sequence typing (MLST) profile determination, identification of antimicrobial resistance determinants, and phylogeny.
Seventy-six were isolated and 64 isolates underwent WGS. Typhi (72%) was the most prevalent serotype. Notable was the occurrence of invasive non-typhoidal Typhimurium ST313 (3%), resistance to cephalosporins (4%) and ciprofloxacin (5%), multidrug resistance (46%), and reduced susceptibility to ciprofloxacin (30%) and imipenem (3%). Phylogenetic cluster analysis showed multiple serovars with a wide range of genetic diversity.
The genetic diversity of Typhi, high prevalence of multidrug resistance, and the emergence of ciprofloxacin and cephalosporin resistance warrants improved hygiene and water and sanitation provision, continued surveillance to apprise antibiograms and inform policy, and the introduction of the typhoid conjugate vaccine.
本研究调查了2018 - 2019年赞比亚卢萨卡一家三级转诊医院从血流感染中分离出的[细菌名称未给出]的抗菌药物敏感性和基因组分析。
这是一项基于医院的前瞻性研究，涉及提交给大学教学医院微生物实验室的常规血培养样本。通过传统方法和自动化方法实现[细菌名称未给出]的鉴定和抗菌药物敏感性分析。进行了全基因组测序（WGS），并对序列数据输出进行处理，以进行菌种鉴定、血清型测定、多位点序列分型（MLST）分析、抗菌药物耐药决定因素鉴定和系统发育分析。
分离出76株[细菌名称未给出]，其中64株进行了WGS。伤寒杆菌（72%）是最常见的血清型。值得注意的是侵袭性非伤寒沙门氏菌鼠伤寒血清型ST313的出现（3%）、对头孢菌素的耐药性（4%）和环丙沙星的耐药性（5%）、多重耐药性（46%）以及对环丙沙星（30%）和亚胺培南（3%）的敏感性降低。系统发育聚类分析显示多种[细菌名称未给出]血清型具有广泛的遗传多样性。
伤寒杆菌的遗传多样性、多重耐药性的高流行率以及环丙沙星和头孢菌素耐药性的出现，需要改善卫生条件以及水和环境卫生设施，持续监测以了解抗菌谱并为政策提供信息，以及引入伤寒结合疫苗。
