Vargas Juan Martín, Moreno Mochi Maria Paula, Nuñez Juan Manuel, Mochi Silvana, Cáceres Mariel, Del Campo Rosa, Jure María Angela
LABACER, Institute of Microbiology 'Luis C. Verna', Faculty of Biochemistry, Chemistry and Pharmacy, National University of Tucuman, Tucuman, Argentina.
Angel Cruz Padilla Hospital, Tucuman, Argentina.
J Med Microbiol. 2023 Jan;72(1). doi: 10.1099/jmm.0.001635.
is a nosocomial pathogen associated with drug resistance and healthcare-associated infections. is associated with hospital-acquired infections with the ability to acquire mechanisms of resistance to reserve antimicrobials; its clinical behaviour has been poorly documented. We proposed to investigate an outbreak of carbapenem-resistant in a hospital that persisted for 4 months. The primary aim was to evaluate the molecular characteristics and the clonal relationships among the isolates. We characterized isolates by polymerase chain reaction (PCR) and pulsed-field gel electrophoresis (PFGE). The information was integrated with clinical and epidemiological data. Fourteen strains were disseminated in an intensive care unit and different wards at the hospital. The overall mortality was 42.8 %, and mortality attributed to infection was 21.4 %; strains showed high rates of resistance to most of the antimicrobials tested and carried , and genes. PFGE analysis indicated 2 PFGE groups; 12/14 isolates were associated with subgroup A and were likely to be primarily responsible for the first isolation and subsequent dissemination. The outbreak characteristics data showed prolonged hospitalization and previous use of antibiotics as potential risk factors. We consider that it is essential to perform phenotypic and genotypic identification of early genetic resistance mechanisms in isolates, not only from infection sites but also from colonization, to prevent the spread of these multidrug-resistant (MDR) isolates.
是一种与耐药性和医疗保健相关感染有关的医院病原体。与医院获得性感染相关，具有获得对储备抗菌药物耐药机制的能力；其临床行为记录较少。我们提议对一家医院持续4个月的耐碳青霉烯类 暴发进行调查。主要目的是评估分离株的分子特征和克隆关系。我们通过聚合酶链反应（PCR）和脉冲场凝胶电泳（PFGE）对分离株进行了鉴定。这些信息与临床和流行病学数据相结合。14株菌株在医院的重症监护病房和不同病房传播。总死亡率为42.8%，感染导致的死亡率为21.4%；菌株对大多数测试抗菌药物显示出高耐药率，并携带 、 和 基因。PFGE分析表明有2个PFGE组；14株分离株中有12株与A亚组相关，可能是首次分离及随后传播的主要原因。暴发特征数据显示住院时间延长和先前使用抗生素是潜在风险因素。我们认为，不仅要对感染部位，还要对定植部位的 分离株早期遗传耐药机制进行表型和基因型鉴定，对于防止这些多重耐药（MDR）分离株的传播至关重要。
