Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Jpn J Infect Dis. 2023 Jan 24;76(1):7-13. doi: 10.7883/yoken.JJID.2022.101. Epub 2022 Aug 31.
In this study, Aeromonas spp. were re-identified, and the clinical aspects associated with Aeromonas bacteremia, as well as drug resistance and virulence genes, were elucidated. A total of 188 isolates were classified into 7 Aeromonas spp. using housekeeping gene sequencing, which was the standard to assess the accuracy of the VITEK MALDI-TOF system and the VITEK2 Compact system. The VITEK MS system and housekeeping gene sequencing had a 39.89% clear coincidence rate, whereas the VITEK2 Compact system and the standard had a 2.13% coincidence rate. Aeromonas bacteremia was associated with septic shock, hematologic malignancy, and post-hepatitic cirrhosis. Hematological malignancy, hypoproteinemia, systemic steroid use, central venous catheterization, and virulence genes act and ast were linked to poor outcomes. Aeromonas bacteremia had a 37.5% mortality rate; however, differences in mortality rates among Aeromonas spp. were observed. According to the broth microdilution method, over 90% of isolates were sensitive to most antimicrobials, except ceftriaxone (83.33%) and imipenem (83.33%). Polymerase chain reaction and DNA sequencing verified the presence of drug resistance genes; bla was detected in 3 isolates, while bla was found in one isolate. In summary, common methods for identifying Aeromonas spp. are ineffective. Immunocompromised patients have a higher risk of infection and mortality. Furthermore, carbapenem resistance is a serious problem.
在这项研究中,我们重新鉴定了气单胞菌属,并阐明了与气单胞菌菌血症相关的临床方面、耐药性和毒力基因。通过管家基因测序将 188 株分离物分为 7 种气单胞菌属,这是评估 VITEK MALDI-TOF 系统和 VITEK2 Compact 系统准确性的标准。VITEK MS 系统和管家基因测序的符合率为 39.89%,而 VITEK2 Compact 系统和标准的符合率为 2.13%。气单胞菌菌血症与感染性休克、血液系统恶性肿瘤和肝炎后肝硬化有关。血液系统恶性肿瘤、低蛋白血症、全身类固醇使用、中心静脉置管和毒力基因 act 和 ast 与不良预后相关。气单胞菌菌血症的死亡率为 37.5%;然而,不同气单胞菌属之间的死亡率存在差异。根据肉汤微量稀释法,超过 90%的分离物对大多数抗菌药物敏感,除头孢曲松(83.33%)和亚胺培南(83.33%)外。聚合酶链反应和 DNA 测序证实了耐药基因的存在;在 3 株分离物中检测到 bla,在 1 株分离物中检测到 bla。总之,鉴定气单胞菌属的常用方法效果不佳。免疫功能低下的患者感染和死亡的风险更高。此外,碳青霉烯类耐药是一个严重的问题。