Giufrè Maria, Errico Giulia, Monaco Monica, Del Grosso Maria, Sabbatucci Michela, Pantosti Annalisa, Cerquetti Marina, Pagnotta Michela, Marra Manuela, Carollo Maria, Rossini Angelo, Fogato Elena, Cesana Elisabetta, Gentiloni Silverj Flaminia, Zabzuni Dorjan, Tinelli Marco
Department of Infectious Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy.
Ministry of Health, Directorate General Health Prevention, Communicable Diseases and International Prophylaxis, 00144 Rome, Italy.
Microorganisms. 2022 Aug 3;10(8):1561. doi: 10.3390/microorganisms10081561.
The spread of carbapenemase-producing (CP) Enterobacterales is currently a worldwide concern, especially in the elderly. Twelve CP- isolated from rectal swabs of colonized inpatients aged ≥65 years from four hospitals in two Italian cities (Milan and Rome) were analyzed by whole genome sequencing (WGS) to obtain multi-locus sequence typing (MLST), identification of carbapenemase-encoding genes, resistome, plasmid content, and virulence genes. MLST analysis showed the presence of 10 unrelated lineages: ST410 (three isolates from three different hospitals in two cities) and ST12, ST38, ST69, ST95, ST131, ST189, ST648, ST1288, and ST1598 (one isolate each). Most isolates (9/12, 75%) contained a serine-β-lactamase gene (5 , 2 , and 2 ), while three isolates harbored a metallo-β-lactamase gene (two and one ). In most CP-, the presence of more than one plasmid was observed, with the predominance of IncF. Several virulence genes were detected. All isolates contained genes enhancing the bacterial fitness, such as and C, and all isolates but one, H, encoding type 1 fimbriae. In conclusion, CP- clones colonizing elderly patients showed heterogeneous genetic backgrounds. We recommend strict surveillance to monitor and prevent the spread of successful, high-risk clones in healthcare settings.
产碳青霉烯酶（CP）肠杆菌科细菌的传播目前是一个全球关注的问题，在老年人中尤为如此。对从意大利两个城市（米兰和罗马）的四家医院中年龄≥65岁的住院定植患者直肠拭子中分离出的12株CP菌株进行了全基因组测序（WGS）分析，以获得多位点序列分型（MLST）、碳青霉烯酶编码基因鉴定、耐药组、质粒含量和毒力基因。MLST分析显示存在10个不相关的谱系：ST410（来自两个城市三家不同医院的三株分离株）以及ST12、ST38、ST69、ST95、ST131、ST189、ST648、ST1288和ST1598（各一株）。大多数分离株（9/12，75%）含有丝氨酸-β-内酰胺酶基因（5株、2株和2株），而三株分离株含有金属-β-内酰胺酶基因（两株 和一株 ）。在大多数CP菌株中，观察到存在不止一种质粒，以IncF为主。检测到了几个毒力基因。所有分离株都含有增强细菌适应性的基因，如 和C，除一株H外的所有分离株都编码1型菌毛。总之，定植于老年患者的CP克隆显示出异质的遗传背景。我们建议进行严格监测，以监控和预防医疗环境中成功的高风险克隆的传播。
