Sumbana José João, Santona Antonella, Abdelmalek Nader, Fiamma Maura, Deligios Massimo, Manjate Alice, Sacarlal Jahit, Rubino Salvatore, Paglietti Bianca
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy.
Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo P.O. Box 257, Mozambique.
Antibiotics (Basel). 2023 Sep 12;12(9):1439. doi: 10.3390/antibiotics12091439.
Globally, antibiotic-resistant spp. cause healthcare-associated infections with high mortality rates, and the rise of hypervirulent (hv) poses a significant threat to human health linked to community-acquired infections and increasing non-susceptibility. We investigated the phenotypic and genetic features of 36 isolates recovered from invasive infections at Hospital Central of Maputo in Mozambique during one year. The majority of the isolates displayed multidrug resistance (MDR) (29/36) to cephalosporins, gentamicin, ciprofloxacin, and trimethoprim-sulfamethoxazole but retained susceptibility to amikacin, carbapenems, and colistin. Most isolates were ESBLs-producing (28/36), predominantly carrying the and other beta-lactamase genes (, , and ). Among the 16 genomes sequenced, multiple resistance genes from different antibiotic classes were identified, with , mostly in the IS-- genetic environment, co-existing with and in five isolates. Our results highlight the presence of polyclonal MDR ESBL-producing from eight sequence types (ST), mostly harbouring distinct yersiniabactin within the conjugative integrative element (ICE). Further, we identified susceptible hv ST23, O1-K1-type isolates carrying yersiniabactin (/ICEKp10), colibactin, salmochelin, aerobactin, and hypermucoid locus (), associated with severe infections in humans. These findings are worrying and underline the importance of implementing surveillance strategies to avoid the risk of the emergence of the most threatening MDR hv.
在全球范围内，抗生素耐药菌会引发死亡率很高的医疗保健相关感染，而高毒力菌的出现对与社区获得性感染及耐药性增加相关的人类健康构成了重大威胁。我们调查了莫桑比克马普托中央医院一年内从侵袭性感染中分离出的36株菌株的表型和基因特征。大多数分离株对头孢菌素、庆大霉素、环丙沙星和甲氧苄啶-磺胺甲恶唑表现出多重耐药性（MDR）（29/36），但对阿米卡星、碳青霉烯类和黏菌素仍敏感。大多数分离株产超广谱β-内酰胺酶（ESBLs）（28/36），主要携带blaCTX-M和其他β-内酰胺酶基因（blaSHV、blaTEM和blaOXA）。在测序的16个基因组中，鉴定出了来自不同抗生素类别的多个耐药基因，blaCTX-M大多存在于IS26-blaCTX-M遗传环境中，在5株分离株中与blaSHV和blaTEM共存。我们的结果突出表明，存在来自8种序列类型（ST）的多克隆产MDR ESBLs的肺炎克雷伯菌，大多在接合整合元件（ICE）内携带不同的yersiniabactin。此外，我们鉴定出了对多种抗生素敏感的高毒力ST23、O1-K1型分离株，它们携带yersiniabactin（pYV/ICEKp10）、大肠杆菌素、沙门菌素、气杆菌素和高黏液样位点（mrkABCDF），与人类严重感染有关。这些发现令人担忧，并强调了实施监测策略以避免出现最具威胁性的MDR高毒力菌风险的重要性。
