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从大学医院设施住院患者中分离出的耐碳青霉烯菌株的下一代测序

Next-Generation Sequencing of Carbapenem-Resistant Strains Isolated from Patients Hospitalized in the University Hospital Facilities.

作者信息

Koreň Ján, Andrezál Michal, Drahovská Hana, Hubenáková Zuzana, Liptáková Adriána, Maliar Tibor

机构信息

Institute of Microbiology, Faculty of Medicine, Comenius University, University Hospital Bratislava, 81108 Bratislava, Slovakia.

Department of Molecular Biology, Faculty of Natural Sciences, Comenius University, 84215 Bratislava, Slovakia.

出版信息

Antibiotics (Basel). 2022 Nov 3;11(11):1538. doi: 10.3390/antibiotics11111538.

Abstract

Carbapenem-resistant (CR) represents an urgent worldwide threat. We focused on CR in selected facilities of the University Hospital Bratislava (UHB) to investigate sequence types (STs), clonal relatedness, and antimicrobial resistance. Suspected carbapenem-nonsusceptible strains were obtained from hospitalized patients. Further examination included carbapenemase confirmation, cgMLST, and quantitative susceptibility testing. Of the total 41 CR strains, 26 (63.4%) were determined as ST11 in hospital No. 1; of these ST11, 22 (84.6%) were found in the first internal clinic. Six (14.6%) ST258 and three (7.3%) ST584 occurred in hospital No. 2; the most, i.e., four (66.7%), ST258 were detected in the geriatric clinic. In hospital No. 3, we found two (4.8%) ST584 and one (2.4%) ST258. Of the ST11 set, 24 (92.3%) produced NDM-1. Furthermore, seven (87.5) ST258 and five (100%) ST584 strains generated KPC-2. Antimicrobial resistance was as follows: ertapenem 97.6%, meropenem 63.4%, tigecycline 7.3%, eravacycline 7.3%, and colistin 2.5%. We revealed a presumably epidemiological association of ST11 with transmission, particularly in the first internal clinic of hospital No. 1, while ST258 and ST584 were related to interhospital dissemination between medical facilities No. 2 and No. 3. It is essential to prevent the circulation of these pathogens within and between healthcare facilities.

摘要

耐碳青霉烯类(CR)是一种全球范围内的紧迫威胁。我们聚焦于布拉迪斯拉发大学医院(UHB)特定科室的CR情况,以调查序列型(STs)、克隆相关性及抗菌药物耐药性。疑似耐碳青霉烯类菌株取自住院患者。进一步检测包括碳青霉烯酶确认、核心多位点序列分型(cgMLST)及定量药敏试验。在总共41株CR菌株中,医院1的26株(63.4%)被确定为ST11;在这些ST11菌株中,22株(84.6%)发现于第一内科诊所。医院2出现了6株(14.6%)ST258和3株(7.3%)ST584;其中最多的,即4株(66.7%)ST258在老年病科被检测到。在医院3,我们发现了2株(4.8%)ST584和1株(2.4%)ST258。在ST11菌株组中,24株(92.3%)产生NDM-1。此外,7株(87.5%)ST258和5株(100%)ST584菌株产生KPC-2。抗菌药物耐药情况如下:厄他培南97.6%、美罗培南63.4%、替加环素7.3%、依拉环素7.3%、黏菌素2.5%。我们揭示了ST11与传播之间可能存在的流行病学关联,尤其是在医院1的第一内科诊所,而ST258和ST584与医疗设施2和3之间的医院间传播有关。防止这些病原体在医疗机构内部及之间传播至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03d3/9686475/e62d64193e0f/antibiotics-11-01538-g001.jpg

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