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中国感染及肠道定植住院患者中高毒力耐碳青霉烯菌的比较基因组分析

Comparative Genomic Analysis of Hypervirulence Carbapenem-Resistant from Inpatients with Infection and Gut Colonization, China.

作者信息

He Wan, Wu Changbu, Chen Guanping, Zhang Guili, Zhao Zihan, Wen Shu'an, Zhou Yuan, Deng Xue, Feng Yu, Zhong Lan-Lan, Tian Guo-Bao, Dai Min

机构信息

School of Laboratory Medicine, Chengdu Medical College, Chengdu, 610500, People's Republic of China.

Department of Immunology and Microbiology, Advanced Medical Technology Center, The First Affiliated Hospital, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Aug 14;16:5251-5261. doi: 10.2147/IDR.S416770. eCollection 2023.

DOI:10.2147/IDR.S416770
PMID:37601558
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10437719/
Abstract

BACKGROUND

The emergence and spread of hypervirulent carbapenem-resistant (hv-CRKP) is a potential epidemiological threat that needs to be monitored. However, the transmission and pathogenic characteristics of hv-CRKP in China remain unclear. We investigated the epidemiological characteristics of gut colonized hv-CRKP in a hospital in Guangdong Province, China.

METHODS

A total of 46 gut colonized hv-CRKP isolates were collected from Sun Yat-Sen Memorial Hospital (Guangzhou, China) from August 31st to December 31st, 2021. Minimum inhibitory concentrations (MICs) were obtained for 15 antibiotics for 46 hv-CRKP isolates. BALB/C mice infection model and mucoviscosity assay was used to evaluate the virulence of the isolates. The characteristics of genome, phylogenetic relationship and the structure of the plasmid of 46 gut colonized hv-CRKP isolates were compared with pathogenic isolates from GeneBank based on whole-genome data.

RESULTS

The hv-CRKP isolation rate of all gut colonized carbapenem-resistant was 17% (46/270), and the intestinal colonization rate of hv-CRKP was irrelevant to the sex, age, department of hospitalization, and history of antibiotic use of the host. The gut colonized hv-CRKP showed pandrug resistance and hypervirulence. The gut colonized hv-CRKP and pathogenic hv-CRKP prevalent in China were mainly ST11 hv-CRKP and had two major epidemic clades. The similarities in genomic characteristics between gut colonized hv-CRKP and pathogenic hv-CRKP were consistent. The gut colonized hv-CRKP carried an incomplete structure pK2044 virulence plasmid from hypervirulent NTUH-K2044 by analyzing the virulence plasmid structure.

CONCLUSION

Our results suggest that the gut colonized ST11 hv-CRKP may serve as a reservoir for the clinical pathogenic ST11 HV-CRKP. It is necessary to further strengthen the monitoring of gut colonized hv-CRKP and research the potential mechanism of infection caused by gut colonized hv-CRKP.

摘要

背景

高毒力耐碳青霉烯类肺炎克雷伯菌（hv-CRKP）的出现和传播是一个需要监测的潜在流行病学威胁。然而，hv-CRKP在中国的传播和致病特征仍不清楚。我们调查了中国广东省一家医院肠道定植的hv-CRKP的流行病学特征。

方法

2021年8月31日至12月31日期间，从中山大学附属孙逸仙纪念医院（中国广州）共收集了46株肠道定植的hv-CRKP分离株。对46株hv-CRKP分离株进行了15种抗生素的最低抑菌浓度（MIC）测定。采用BALB/C小鼠感染模型和黏液粘度测定法评估分离株的毒力。基于全基因组数据，将46株肠道定植的hv-CRKP分离株的基因组特征、系统发育关系和质粒结构与来自GenBank的致病分离株进行比较。

结果

所有肠道定植的耐碳青霉烯类菌株中hv-CRKP的分离率为17%（46/270），hv-CRKP的肠道定植率与宿主的性别、年龄、住院科室和抗生素使用史无关。肠道定植的hv-CRKP表现出泛耐药性和高毒力。在中国流行的肠道定植hv-CRKP和致病hv-CRKP主要是ST11 hv-CRKP，有两个主要的流行分支。肠道定植hv-CRKP和致病hv-CRKP在基因组特征上的相似性是一致的。通过分析毒力质粒结构，肠道定植的hv-CRKP携带了来自高毒力NTUH-K2044的不完整结构pK2044毒力质粒。

结论

我们的结果表明，肠道定植的ST11 hv-CRKP可能是临床致病ST11 HV-CRKP的储存库。有必要进一步加强对肠道定植hv-CRKP的监测，并研究肠道定植hv-CRKP引起感染的潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/39124fb9d694/IDR-16-5251-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/48634031c2cb/IDR-16-5251-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/ef6e1c13f2ba/IDR-16-5251-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/486781e669c5/IDR-16-5251-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/8665a5af14cd/IDR-16-5251-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/39124fb9d694/IDR-16-5251-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/48634031c2cb/IDR-16-5251-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/ef6e1c13f2ba/IDR-16-5251-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/486781e669c5/IDR-16-5251-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/8665a5af14cd/IDR-16-5251-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7242/10437719/39124fb9d694/IDR-16-5251-g0005.jpg

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