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从尿路感染患者中分离的高毒力株的分子和临床特征。

Molecular and clinical characterization of hypervirulent isolates from individuals with urinary tract infections.

机构信息

Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Cell Infect Microbiol. 2022 Aug 8;12:925440. doi: 10.3389/fcimb.2022.925440. eCollection 2022.

Abstract

Despite being a significant public health concern, hypervirulent (hvKP) has rarely been investigated in urinary tract infections (UTIs). To investigate the molecular and clinical characterization of hvKP in UTIs, we collected strains and clinical data from patients with UTIs. HvKP was confirmed by virulence-related genes and the model and sequenced by next-generation sequencing. Our data showed that 30/121 isolates were hvKP [17 carbapenem-resistant hypervirulent (CR-hvKP), 12 hvKP, and 1 extended-spectrum β-lactamase-producing hvKP]; these had higher resistance to most antimicrobials and were more likely to cause complicated UTIs (cUTIs). Notably, the mucoid phenotype-regulating genes and were truncated in 3 and 19 hvKP, respectively. Eight serotypes were detected and divided into three groups: K64 ( = 17), K1/K2 ( = 6), and others ( = 7). Furthermore, 16/17 K64 hvKP isolates were CR-hvKP but with a lower mortality rate of as the truncated incurred high fitness cost to the isolates. In addition, all K64 isolates belonged to ST11 with the same cluster, and in two of these strains (KP88 and KP92) gene was successfully transferred to EC600. Genetic environment analysis showed that IS--IS- -IS may be the core structure in the horizontal transfer of . The highest mortality rate among the infected was observed in the K1/K2 group. In conclusion, hvKP had a higher resistance rate and was more likely to lead to cUTIs. Convergence of hypervirulence and carbapenem resistance in a transmissible ST11 clone of K64 was mediated by a plasmid in UTIs. Therefore, surveillance of hvKP in UTIs should be strengthened.

摘要

尽管高毒力 (hvKP) 是一个重大的公共卫生问题,但在尿路感染 (UTI) 中很少对其进行研究。为了研究 UTI 中 hvKP 的分子和临床特征,我们从 UTI 患者中收集了 株和临床数据。通过毒力相关基因和模型鉴定并对 hvKP 进行了下一代测序。我们的数据显示,在 121 株分离株中有 30 株为 hvKP[17 株耐碳青霉烯类高毒力 (CR-hvKP)、12 株 hvKP 和 1 株产超广谱β-内酰胺酶的 hvKP];这些菌株对大多数抗菌药物的耐药性更高,更有可能引起复杂性尿路感染 (cUTI)。值得注意的是,在 3 株和 19 株 hvKP 中,分别截短了调节黏液表型的基因 和 。检测到 8 种血清型,分为 3 组:K64(=17)、K1/K2(=6)和其他(=7)。此外,16/17 株 K64 hvKP 分离株为 CR-hvKP,但死亡率较低,因为截短的 会对分离株造成高适应代价。此外,所有 K64 分离株均属于 ST11,具有相同的聚类,在其中 2 株(KP88 和 KP92)中成功地将 基因转移到 EC600 中。遗传环境分析表明,IS--IS- -IS 可能是 水平转移的核心结构。在 K1/K2 组感染的 中观察到的最高死亡率。总之,hvKP 的耐药率更高,更有可能导致 cUTI。在 K64 的可传播 ST11 克隆中,高毒力和碳青霉烯类耐药性的趋同是由质粒介导的。因此,应加强对 UTI 中 hvKP 的监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65ac/9393326/549f04ab4478/fcimb-12-925440-g001.jpg

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