Ortiz de la Rosa José Manuel, Rodríguez-Villodres Ángel, Casimiro-Soriguer Carlos S, Ruiz-Pérez De Pipaón Maite, Briones Eduardo, Aznar Fernández María, Lepe José Antonio
Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocío, Seville, Spain.
Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain.
JAC Antimicrob Resist. 2022 Sep 5;4(5):dlac090. doi: 10.1093/jacamr/dlac090. eCollection 2022 Oct.
Seven CTX-M-27-producing strains were isolated at the University Hospital Virgen del Rocío (Seville, Spain) microbiology service from October to November 2021.
To offer extensive information on the microbiological and molecular epidemiology results of the seven isolates and compare them with other previously documented CTX-M-27-producing associated with MSM transmission.
isolated from stool samples of patients with acute diarrhoea were identified through biochemical and serological typing. Whole characterization of the seven isolates was performed by sequencing with MinION Mk1C followed by genomic and molecular analysis.
All the isolates were resistant to penicillins, cephalosporins, fluoroquinolones, cotrimoxazole and azithromycin. Sequencing showed the presence of several resistance determinants, outstanding , azithromycin resistance genes [ and )], and mutations in the QRDRs. All isolates belonged to the same hierarchical clustering of cgMLST (HierCC) with five allele distance (HC5) scheme v1 from EnteroBase. However, they presented differences in plasmid composition, with all seven isolates harbouring IncFII, IncB/O/K/Z and ColE1-like while SH2, SH6 and SH7 had IncFIB only. Our isolates were closely related to others from Spain (HC5; 98748), Australia (HC5; 98748) and the UK (HC5; 98748), which were also associated with MSM transmission. Nevertheless, the structure of the non-chromosomal genetic elements and the genetic context of presented a certain variability compared with isolates from other countries and among them.
This study confirms the emergence of CTX-M-27-producing (ST152) associated with MSM transmission in Spain, adding it to the Europe outbreak list and reinforcing the necessity of active surveillance and control of this high-risk clone.
2021年10月至11月期间，在西班牙塞维利亚的罗西奥圣母大学医院微生物科分离出7株产CTX-M-27的菌株。
提供有关这7株分离株的微生物学和分子流行病学结果的广泛信息，并将它们与其他先前记录的与男男性行为者传播相关的产CTX-M-27菌株进行比较。
从急性腹泻患者的粪便样本中分离出的菌株通过生化和血清学分型进行鉴定。使用MinION Mk1C进行测序，随后进行基因组和分子分析，对这7株分离株进行全面表征。
所有分离株对青霉素、头孢菌素、氟喹诺酮类、复方新诺明和阿奇霉素均耐药。测序显示存在多个耐药决定因素，突出的有阿奇霉素耐药基因（erm(B)和mph(A)）以及喹诺酮耐药决定区的突变。所有分离株都属于EnteroBase中cgMLST（层次聚类）的同一层次聚类，采用五个等位基因距离（HC5）方案v1。然而，它们在质粒组成上存在差异，所有7株分离株都携带IncFII、IncB/O/K/Z和ColE1样质粒，而SH2、SH6和SH7仅携带IncFIB。我们的分离株与来自西班牙（HC5；98748）、澳大利亚（HC5；98748）和英国（HC5；98748）的其他分离株密切相关，这些分离株也与男男性行为者传播有关。然而，与其他国家的分离株相比，非染色体遗传元件的结构和blaCTX-M-27的遗传背景存在一定的变异性，且在它们之间也存在差异。
本研究证实了西班牙出现了与男男性行为者传播相关的产CTX-M-27（ST152）菌株，将其添加到欧洲疫情名单中，并强化了对这一高风险克隆进行主动监测和控制的必要性。
