南非 2017 至 2019 年基于国家级实验室的鲍曼不动杆菌复合体监测。
Acinetobacter baumannii complex, national laboratory-based surveillance in South Africa, 2017 to 2019.
机构信息
Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, Johannesburg, South Africa.
Division of Clinical Microbiology and Infectious Diseases, Faculty of Health Science, School of Pathology of the University of the Witwatersrand and the National Health Laboratory Service (NHLS), Johannesburg, South Africa.
出版信息
PLoS One. 2022 Aug 4;17(8):e0271355. doi: 10.1371/journal.pone.0271355. eCollection 2022.
OBJECTIVE
We aimed to provide an analysis of A. baumannii complex (ABC) isolated from blood cultures in South Africa.
MATERIALS AND METHODS
ABC surveillance was conducted from 1 April 2017 to 30 September 2019 at 19 hospital sites from blood cultures of any age and sex. Organism identification was performed using the MALDI-TOF MS and antimicrobial susceptibility testing (AST), MicroScan Walkaway System. We confirmed colistin resistance with Sensititre, FRCOL panel, and selected for whole-genome sequencing.
RESULTS
During the study period, we identified 4822 cases of ABC, of which 2152 cases were from 19 enhanced surveillance sites were reported during the enhanced surveillance period (1 August 2018 to 30 September 2019). Males accounted for 54% (2611/4822). Of the cases with known age, 41% (1968/4822) were infants (< 1-year-old). Seventy-eight percent (1688/2152) of cases had a known hospital outcome, of which 36% (602/1688) died. HIV status was known for 69% (1168/1688) of cases, and 14% (238/1688) were positive. Eighty-two percent (1389/1688) received antimicrobial treatment in admission. Three percent (35/1389) of cases received single colistin. Four percent (75/2033) were resistant to colistin. At least 75% of the isolates (1530/2033) can be classified as extensively drug-resistant (XDR), with resistance to most antibiotics except for colistin. The majority, 83% (20/24), of the colistin-resistant isolates were of the sequence type (ST) 1. Resistance genes, both plasmid- and chromosomal- mediated were not observed. Although all isolates had, nine efflux pump genes related to antimicrobial resistance.
CONCLUSION
Our surveillance data contributed to a better understanding of the natural course of A. baumannii disease, the patient characteristics among infants, and the level of resistance. At least two-thirds of the isolates were extensively drug-resistant, and four percent of isolates were resistant to colistin.
目的
我们旨在对南非血液培养物中分离出的鲍曼不动杆菌复合体（ABC）进行分析。
材料和方法
2017 年 4 月 1 日至 2019 年 9 月 30 日，19 家医院对各年龄段和性别的血液培养物进行了 ABC 监测。采用 MALDI-TOF MS 和药敏试验（AST）、MicroScan Walkaway 系统进行病原体鉴定。我们使用 Sensititre、FRCOL 试剂盒确认了多粘菌素耐药性，并选择进行全基因组测序。
结果
在研究期间，我们共发现 4822 例 ABC，其中 2152 例来自强化监测期间（2018 年 8 月 1 日至 2019 年 9 月 30 日）的 19 家强化监测点。男性占 54%（2611/4822）。已知年龄的病例中，41%（1968/4822）为婴儿（<1 岁）。已知 78%（1688/2152）例的住院结局，其中 36%（602/1688）死亡。69%（1168/1688）例的病例已知 HIV 状态，其中 14%（238/1688）为阳性。82%（1389/1688）例在入院时接受了抗菌治疗。3%（35/1389）例接受了单一粘菌素治疗。4%（75/2033）例对粘菌素耐药。至少 75%（1530/2033）的分离株可归类为广泛耐药（XDR），对大多数抗生素耐药，除粘菌素外。大多数（83%，20/24）耐粘菌素的分离株为 ST1 型。未观察到质粒和染色体介导的耐药基因。尽管所有分离株均含有 9 个与抗菌药物耐药性相关的外排泵基因。
结论
我们的监测数据有助于更好地了解鲍曼不动杆菌病的自然病程、婴儿患者的特征以及耐药水平。至少三分之二的分离株为广泛耐药，4%的分离株对粘菌素耐药。
Zotero 插件