Department of Pharmacy, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Shaoxing, Zhejiang, China.
Department of Traditional Chinese Medicine, Hangzhou Linping District Hospital of Integrated Chinese and Western Medicine, Hangzhou, China.
Front Cell Infect Microbiol. 2023 Aug 25;13:1227063. doi: 10.3389/fcimb.2023.1227063. eCollection 2023.
The emergence of carbapenemase-producing spp. has been widely reported and become a global threat. However, carbapenem-resistant strains are relatively rare and without comprehensive genetic structure analysis, especially for isolates collected from human specimen. Here, one AYTCM strain, co-producing NDM-1, OXA-58, and PER-1 enzymes, was isolated from sputum in China in 2018. Antimicrobial susceptibility testing showed that it was resistant to meropenem, imipenem, ceftazidime, ciprofloxacin, and cefoperazone/sulbactam. Whole-genome sequencing and bioinformatic analysis revealed that it possessed 11 plasmids. and genes were located in the pAYTCM-1 plasmid. Especially, a complex class 1 integron consisted of a 5' conserved segment (5' CS) and 3' CS, which was found to carry sul1, arr-3, qnrVC6 cassettes. Moreover, the gene was located in 41,087 conjugative plasmids and was quite stable even after 70 passages under antibiotics-free conditions. In addition, six prophage regions were identified. Tracking of closely related plasmids in the public database showed that pAYTCM-1 was similar to pXBB1-9, pOXA23_010062, pOXA58_010030, and pAcsw19-2 plasmids, which were collected from the strains of sewage in China. Concerning the pAYTCM-3 plasmids, results showed that strains were collected from different sources and their hosts were isolated from various countries, such as China, USA, Japan, Brazil, and Mexico, suggesting that a wide spread occurred all over the world. In conclusion, early surveillance is warranted to avoid the extensive spread of this high-risk clone in the healthcare setting.
产碳青霉烯酶 种的出现已被广泛报道，并成为全球威胁。然而，耐碳青霉烯 株相对较少，且缺乏全面的遗传结构分析，特别是对于从人体标本中分离出的菌株。在这里，我们从 2018 年中国的一份痰标本中分离到一株同时产 NDM-1、OXA-58 和 PER-1 酶的 AYTCM 菌株。药敏试验显示，该菌株对美罗培南、亚胺培南、头孢他啶、环丙沙星和头孢哌酮/舒巴坦耐药。全基因组测序和生物信息学分析显示，它携带 11 个质粒。blaNDM-1 和 blaOXA-58 基因位于 pAYTCM-1 质粒上。特别是，一个复杂的类 1 整合子由 5' 保守序列（5'CS）和 3' CS 组成，携带 sul1、arr-3、qnrVC6 盒。此外，blaCTX-M-15 基因位于 41087 个可转移质粒上，即使在无抗生素条件下经过 70 代传代，其仍保持稳定。此外，还鉴定出 6 个噬菌体区域。在公共数据库中追踪密切相关的质粒显示，pAYTCM-1 与 pXBB1-9、pOXA23_010062、pOXA58_010030 和 pAcsw19-2 质粒相似，这些质粒均来自中国污水中的菌株。关于 pAYTCM-3 质粒，结果表明，这些菌株来自不同的来源，其宿主来自中国、美国、日本、巴西和墨西哥等不同国家，表明该高风险克隆已在全球范围内广泛传播。总之，有必要进行早期监测，以避免该高风险克隆在医疗机构中的广泛传播。
