新型冠状病毒肺炎机械通气患者多重耐药菌株的毒力潜力:来自塞尔维亚的首份报告。
Virulence potential of multidrug-resistant isolates from COVID-19 patients on mechanical ventilation: The first report from Serbia.
作者信息
Novović Katarina, Kuzmanović Nedeljković Snežana, Poledica Mirjana, Nikolić Gordana, Grujić Bojana, Jovčić Branko, Kojić Milan, Filipić Brankica
机构信息
Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia.
Institute for Medicinal Plants Research "Dr Josif Pančić", Belgrade, Serbia.
出版信息
Front Microbiol. 2023 Feb 6;14:1094184. doi: 10.3389/fmicb.2023.1094184. eCollection 2023.
Since the WHO declared the COVID-19 pandemic in March 2020, the disease has spread rapidly leading to overload of the health system and many of the patients infected with SARS-CoV-2 needed to be admitted to the intensive care unit (ICU). Around 10% of patients with the severe manifestation of COVID-19 need noninvasive or invasive mechanical ventilation, which represent a risk factor for superinfection. The 64 isolates were recovered from COVID-19 patients admitted to ICU at General Hospital "Dr Laza K. Lazarević" Šabac, Serbia, during the period from December 2020 to February 2021. All patients required mechanical ventilation and mortality rate was 100%. The goal of this study was to evaluate antibiotic resistance profiles and virulence potential of isolates recovered from patients with severe form of COVID-19 who had a need for mechanical ventilation. All tested isolates ( = 64) were sensitive to colistin, while resistant to meropenem, imipenem, gentamicin, tobramycin, and levofloxacin according to the broth microdilution method and MDR phenotype was confirmed. In all tested isolates, representatives of international clone 2 (IC2) classified by multiplex PCR for clonal lineage identification, , , and genes were present, as well as IS insertion sequence upstream of . Clonal distribution of one dominant strain was found, but individual strains showed phenotypic differences in the level of antibiotic resistance, biofilm formation, and binding to mucin and motility. According to PFGE, four isolates were sequenced and antibiotic resistance genes as well as virulence factors genes were analyzed in these genomes. The results of this study represent the first report on virulence potential of MDR from hospital in Serbia.
自世界卫生组织于2020年3月宣布新冠疫情以来,该疾病迅速传播,导致卫生系统不堪重负,许多感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的患者需要入住重症监护病房(ICU)。约10%表现为重症的新冠患者需要无创或有创机械通气,这是发生二重感染的一个危险因素。这64株分离株是在2020年12月至2021年2月期间,从塞尔维亚沙巴茨“拉扎尔·K·拉扎列维奇博士”综合医院ICU收治的新冠患者中分离得到的。所有患者均需要机械通气,死亡率为100%。本研究的目的是评估从有机械通气需求的重症新冠患者中分离得到的菌株的抗生素耐药谱和毒力潜力。根据肉汤微量稀释法,所有测试菌株(n = 64)对黏菌素敏感,而对美罗培南、亚胺培南、庆大霉素、妥布霉素和左氧氟沙星耐药,并证实为多重耐药(MDR)表型。在所有测试菌株中,通过多重PCR进行克隆谱系鉴定,存在国际克隆2(IC2)的代表菌株,以及位于 基因上游的IS插入序列。发现了一种优势菌株的克隆分布,但个别菌株在抗生素耐药水平、生物膜形成、与黏蛋白的结合及运动性方面表现出表型差异。根据脉冲场凝胶电泳(PFGE),对4株分离株进行了测序,并分析了这些基因组中的抗生素耐药基因和毒力因子基因。本研究结果代表了塞尔维亚医院关于MDR菌株毒力潜力的首份报告。