Irenge Leonid M, Ambroise Jérôme, Bearzatto Bertrand, Durant Jean-François, Bonjean Maxime, Gala Jean-Luc
Center for Applied Molecular Technologies, Institute of Experimental and Clinical Research, Université Catholique de Louvain (UCLouvain), 1200 Woluwe-Saint-Lambert, Belgium.
Defence Laboratories Department, ACOS Ops & Trg, Belgian Armed Forces, 1800 Peutie, Belgium.
Microorganisms. 2023 Feb 18;11(2):525. doi: 10.3390/microorganisms11020525.
Multidrug-resistant (MDR) and extended spectrum β-lactamase (ESBL)-producing extra-intestinal are associated with increased morbidity and mortality. This study aimed to characterize the resistance and virulence profiles of extra-intestinal MDR ESBL-producing associated with infections at a tertiary hospital in South-Kivu province, DRC. Whole-genome sequencing (WGS) was carried out on 37 isolates displaying MDR and ESBL-producing phenotype. The assembled genomes were analysed for phylogeny, virulence factors and antimicrobial resistance genes (ARG) determinants. These isolates were compared to sub-Saharan counterparts. isolates displayed a high genetic variability with up to 16 sequence types (ST). AMR was widespread against β-lactamases (including third and fourth-generation cephalosporins, but not carbapenems), aminoglycosides, ciprofloxacin, tetracycline, erythromycin, nitrofurantoin, and cotrimoxazole. The gene was the most common β-lactamase gene among isolates. No carbapenemase gene was found. ARG for aminoglycosides, quinolones, phenicols, tetracyclines, sulfonamides, nitrofurantoin were widely distributed among the isolates. Nine isolates had the colistin-resistant R256G substitution in the efflux pump gene without displaying reduced susceptibility to colistin. Despite carrying virulence genes, none had hypervirulence genes. Our results highlight the genetic diversity of MDR ESBL-producing isolates and underscore the importance of monitoring simultaneously the evolution of phenotypic and genotypic AMR in Bukavu and DRC, while calling for caution in administering colistin and carbapenem to patients.
产超广谱β-内酰胺酶（ESBL）的耐多药（MDR）肠外病原菌与发病率和死亡率增加相关。本研究旨在描述在刚果民主共和国南基伍省一家三级医院分离出的产MDR ESBL的肠外病原菌的耐药性和毒力特征。对37株表现出MDR和产ESBL表型的病原菌进行了全基因组测序（WGS）。对组装好的基因组进行系统发育、毒力因子和抗菌药物耐药基因（ARG）决定因素分析。将这些分离株与撒哈拉以南地区的同类菌株进行比较。分离株表现出高度的遗传变异性，有多达16种序列类型（ST）。AMR广泛存在于对β-内酰胺酶（包括第三代和第四代头孢菌素，但不包括碳青霉烯类）、氨基糖苷类、环丙沙星、四环素、红霉素、呋喃妥因和复方新诺明的耐药中。blaCTX-M基因是分离株中最常见的β-内酰胺酶基因。未发现碳青霉烯酶基因。氨基糖苷类、喹诺酮类、酚类、四环素类、磺胺类、呋喃妥因的ARG在分离株中广泛分布。9株分离株在mcr-1外排泵基因中存在耐黏菌素的R256G替换，但对黏菌素的敏感性未降低。尽管携带毒力基因，但没有一株具有超毒力基因。我们的结果突出了产MDR ESBL病原菌分离株的遗传多样性，并强调了在布卡武和刚果民主共和国同时监测表型和基因型AMR演变的重要性，同时呼吁在给患者使用黏菌素和碳青霉烯类药物时要谨慎。
