Liu Mi, Li Dan, Jia Wei, Ma Jie, Zhao Xue
Department of Clinical Laboratory, Weifang People's Hospital, 151 Guangwen Street, Weifang Shandong Province, 261041, PR China.
J Med Microbiol. 2023 Jan;72(1). doi: 10.1099/jmm.0.001648.
. is part of the family , and is naturally resistant to various antimicrobial drugs. In recent years, outbreaks of severe nosocomial infections caused by carbapenem-resistant (CR-PMI) have been frequently reported. Few studies exist on the whole-genome molecular characteristics of this bacterium in China and elsewhere, which stimulated the implementation of this study.. CR-PMI strains contained the multiple drug resistance genes and exhibited a high resistance rate to commonly used antimicrobial drugs.. Our goals here were to identify resistance mechanisms and homology of CR-PMI strains and provide a theoretical basis for clinical treatment and controlling nosocomial infections.. Bacterial species identification was carried out using matrix-assisted laser desorption/ionization time of flight MS (MALDI-TOF-MS). Antimicrobial susceptibility was determined using the VITEK 2 system and Kirby-Bauer (K-B) disc-diffusion method. Whole-genome sequencing (WGS) was conducted by the Illumina platform NovaSeq sequencer. Antibiotic resistance genes (ARGs) were identified using the NCBI database with Abricate. Plasmid replicon types were identified using PlasmidFinder, available at the Center for Genomic Epidemiology.. Five CR-PMI strains collected in our hospital from July 2019 to September 2021 were resistant to almost all antimicrobial agents except aztreonam (ATM), amikacin (AMK) and cefotetan (CTT). All CR-PMI strains contained the carbapenem resistance gene New Delhi metallo-β-lactamase 1 ( ), and two strains harboured extended-spectrum β-lactamase (ESBL) genes and . The five CR-PMI strains contained 27, 18, 30, 25 and 24 drug-resistance genes, respectively. Most antimicrobial resistance genes were detected for aminoglycosides (=14), followed by cephalosporins (=7). The phylogenetic tree was divided into five evolutionary groups, and the five CR-PMI strains were in the four evolutionary groups B-E. Overall, CR-PMI strains exhibited a high resistance rate to commonly used antimicrobial drugs, and contained the carbapenem resistance gene . The CR-PMI strains showed a polyclonal trend in different wards at different times. Most importantly, all strains identified contained important antimicrobial resistance genes, which may lead to severe drug resistance transmission and fatal multiple resistant bacterial infections.
. 属于 菌属，对多种抗菌药物天然耐药。近年来，耐碳青霉烯类 （CR-PMI） 引起的严重医院感染暴发屡有报道。在中国及其他地区，关于该细菌全基因组分子特征的研究较少，这促使开展本研究。. CR-PMI菌株含有多种耐药基因，对常用抗菌药物表现出高耐药率。. 我们的目标是确定CR-PMI菌株的耐药机制和同源性，为临床治疗和控制医院感染提供理论依据。. 使用基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF-MS）进行细菌种类鉴定。使用VITEK 2系统和 Kirby-Bauer（K-B）纸片扩散法测定抗菌药物敏感性。通过Illumina平台NovaSeq测序仪进行全基因组测序（WGS）。使用带有Abricate的NCBI数据库鉴定抗生素耐药基因（ARGs）。使用可在基因组流行病学中心获取的PlasmidFinder鉴定质粒复制子类型。. 2019年7月至2021年9月在我院收集的5株CR-PMI菌株，除氨曲南（ATM）、阿米卡星（AMK）和头孢替坦（CTT）外，对几乎所有抗菌药物均耐药。所有CR-PMI菌株均含有碳青霉烯耐药基因新德里金属β-内酰胺酶1（ ），两株携带超广谱β-内酰胺酶（ESBL）基因 和 。这5株CR-PMI菌株分别含有27、18、30、25和24个耐药基因。检测到的大多数抗菌耐药基因针对氨基糖苷类（=14），其次是头孢菌素类（=7）。系统发育树分为五个进化组，这5株CR-PMI菌株分属于四个进化组B-E。总体而言，CR-PMI菌株对常用抗菌药物表现出高耐药率，并含有碳青霉烯耐药基因。CR-PMI菌株在不同时间的不同病房呈现多克隆趋势。最重要的是，所有鉴定出的菌株都含有重要的抗菌耐药基因，这可能导致严重的耐药性传播和致命的多重耐药细菌感染。
