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准确鉴定和毒力检测气单胞菌:中国西南部气单胞菌菌血症临床特征及预后的单中心回顾性研究。

Accurate Identification and Virulence Detection of Aeromonas: a Single-Center Retrospective Study on the Clinical Features and Outcomes Associated with Aeromonas Bacteremia in Southwestern China.

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Jpn J Infect Dis. 2023 Jan 24;76(1):7-13. doi: 10.7883/yoken.JJID.2022.101. Epub 2022 Aug 31.

Abstract

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.

摘要

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。

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