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2017 - 2021年中国西南部新生儿患者中分离出的耐碳青霉烯类菌株的基因组特征

Genomic Characteristics of Carbapenem-Resistant Isolated from Neonatal Patients in Southwest China During 2017-2021.

作者信息

Wu Wenjing, Jiang Yongmei, Zhou Wei, Kuang Linghan

机构信息

Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, 610041, People's Republic of China.

出版信息

Infect Drug Resist. 2023 Oct 17;16:6725-6733. doi: 10.2147/IDR.S426565. eCollection 2023.

Abstract

OBJECTIVE

Carbapenem-resistant (CRKP) is spreading worldwide, becoming a serious threat to public health. The present study aimed to analyze the molecular epidemiology and drug resistance mechanism of CRKP isolated from neonatal patients in Sichuan, Southwest China.

METHODS

CRKP isolates were collected from neonatal patients of West China Second University Hospital from June 2017 to June 2021. Antimicrobial susceptibility testing was performed using broth microdilution. Whole-genome sequencing of all isolates were performed to determine the antimicrobial resistance genes, sequence typing, phylogenetic relationships.

RESULTS

In total, 41 nonduplicate CRKP isolates were collected. All isolates were highly resistant to the cephalosporins and carbapenems, however, they were all susceptible to amikacin, tigecycline, ciprofloxacin, and colistin. Various resistance genes were detected, (n = 35, 85.4%) was the predominant carbapenemase genes. The most common replicon type was IncX3, which was harbored by 36 (87.8%) isolates, followed by IncFIB (n = 34, 82.9%), and IncFII (n = 32, 78.0%). The 41 CRKP isolates belonged to 8 sequence types (STs) and ST789 (n = 29, all had ) was the dominant sequence type.

CONCLUSION

The study revealed that was the most dominant carbapenemase resistance gene. ST789 CRKP strains carrying were a tremendous menace to neonates in this hospital. Therefore, effectively implement prevention and control measures need to be taken for the prevention and treatment of CRKP infection in the neonatal ward.

摘要

目的

耐碳青霉烯类肺炎克雷伯菌(CRKP)正在全球范围内传播,对公众健康构成严重威胁。本研究旨在分析从中国西南部四川省新生儿患者中分离出的CRKP的分子流行病学和耐药机制。

方法

收集2017年6月至2021年6月在西部战区总医院新生儿患者中分离出的CRKP菌株。采用肉汤微量稀释法进行药敏试验。对所有分离株进行全基因组测序,以确定抗菌药物耐药基因、序列分型、系统发育关系。

结果

共收集到41株非重复的CRKP分离株。所有分离株对头孢菌素类和碳青霉烯类均高度耐药,但对阿米卡星、替加环素、环丙沙星和黏菌素均敏感。检测到多种耐药基因,(n = 35,85.4%)是主要的碳青霉烯酶基因。最常见的复制子类型是IncX3,36株(87.8%)分离株携带该类型,其次是IncFIB(n = 34,82.9%)和IncFII(n = 32,78.0%)。41株CRKP分离株属于8种序列类型(STs),ST789(n = 29,均携带)是主要的序列类型。

结论

该研究表明是最主要的碳青霉烯酶耐药基因。携带的ST789 CRKP菌株对该医院的新生儿构成巨大威胁。因此,需要有效实施防控措施以预防和治疗新生儿病房的CRKP感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b73a/10590067/b678160c5e6b/IDR-16-6725-g0001.jpg

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