Piccirilli Alessandra, Meroni Elisa, Mauri Carola, Perilli Mariagrazia, Cherubini Sabrina, Pompilio Arianna, Luzzaro Francesco, Principe Luigi
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Clinical Microbiology and Virology Unit, "A. Manzoni" Hospital, 23900 Lecco, Italy.
Antibiotics (Basel). 2023 Feb 23;12(3):439. doi: 10.3390/antibiotics12030439.
The dramatic increase in infections caused by critically multidrug-resistant bacteria is a global health concern. In this study, we characterized the antimicrobial resistance genes (ARGs) of , , and isolated from both surgical wound and rectal swab of a single Italian patient. Bacterial identification was performed by MALDI-TOF MS and the antimicrobial susceptibility was carried out by Vitek 2 system. The characterization of ARGs was performed using next-generation sequencing (NGS) methodology (MiSeq Illumina apparatus). , and were resistant to most β-lactams and β-lactam/β-lactamases inhibitor combinations. strain was susceptible only to colistin. The presence of plasmids (IncN, IncR, IncFIB, ColRNAI and Col (MGD2)) was detected in all Enterobacterales but not in strain. The IncN plasmid and gene were found in , and , suggesting a possible transfer of this gene among the three clinical species. Conjugation experiments were performed using (1 isolate), (2 isolates) and (2 isolates) as donors and J53 as a recipient. The gene was identified by PCR analysis in all transconjugants obtained. The presence of four different bacterial species harboring resistance genes to different classes of antibiotics in a single patient substantially reduced the therapeutic options.
由多重耐药性极强的细菌引起的感染急剧增加是一个全球健康问题。在本研究中，我们对从一名意大利患者的手术伤口和直肠拭子中分离出的[细菌名称1]、[细菌名称2]、[细菌名称3]和[细菌名称4]的抗菌抗性基因（ARGs）进行了表征。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）进行细菌鉴定，并通过Vitek 2系统进行药敏试验。使用下一代测序（NGS）方法（Illumina MiSeq仪器）对ARGs进行表征。[细菌名称1]、[细菌名称2]和[细菌名称3]对大多数β-内酰胺类和β-内酰胺/β-内酰胺酶抑制剂组合耐药。[细菌名称4]菌株仅对黏菌素敏感。在所有肠杆菌科细菌中均检测到质粒（IncN、IncR、IncFIB、ColRNAI和Col（MGD2））的存在，但在[细菌名称4]菌株中未检测到。在[细菌名称1]、[细菌名称2]和[细菌名称3]中发现了IncN质粒和[基因名称]基因，表明该基因可能在这三种临床菌种之间转移。使用[细菌名称1]（1株分离株）、[细菌名称2]（2株分离株）和[细菌名称3]（2株分离株）作为供体，J53作为受体进行接合试验。通过PCR分析在所有获得的转接合子中鉴定出[基因名称]基因。一名患者体内存在四种对不同类抗生素具有抗性基因的不同细菌物种，这大大减少了治疗选择。
