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对中国一家三级教学医院中 种新兴病原体的系统调查。

Systematic investigation of the emerging pathogen of species in a Chinese tertiary teaching hospital.

机构信息

Department of Laboratory Medicine, State Key Laboratory of Complex, Severe, and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences , Beijing, China.

Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing, China.

出版信息

Microbiol Spectr. 2023 Dec 12;11(6):e0164423. doi: 10.1128/spectrum.01644-23. Epub 2023 Oct 24.

Abstract

species have been clinically regarded as rare but emerging opportunistic pathogens causing various infections in humans. pneumonia has often been misdiagnosed as pulmonary tuberculosis due to its clinical presentation resembling tuberculosis-like syndromes. species have also been confused in the laboratory with other phylogenetic bacteria, such as . This study aimed to investigate the clinical, microbiological, and molecular characteristics; species distribution; and antimicrobial susceptibility of species. Immunodeficiency and chronic pulmonary disease appeared to be risk factors for pneumonia, and the presence of bronchiectasis and pulmonary nodules on imaging was highly correlated with this infection. The study confirmed that (heat shock protein 60) and (the secretion ATPase) genes are reliable for identifying species. Additionally, the (stable small RNA) gene showed promise as a tool for discriminating between different species with the shortest sequence length. In terms of antimicrobial susceptibility, quinolones, trimethoprim/sulfamethoxazole, amikacin, minocycline, linezolid, and tigecycline demonstrated potent activity against isolates in our study. The study also proposed a resistance mechanism involving a substitution (S91R) within the quinolone-resistance-determining region of the gene, which confers resistance to levofloxacin and ciprofloxacin. Furthermore, we found that disk diffusion testing is not suitable for testing the susceptibilities of isolates to ciprofloxacin, imipenem, and minocycline. In conclusion, our systematic investigation may contribute to a better understanding of this rare pathogen. species are rare but emerging human pathogens that share remarkable similarities with other mycolic acid-containing genera of the order Actinomycetales, especially . Consequently, misdiagnosis and therapeutic failures can occur in clinical settings. Despite the significance of accurate identification, antimicrobial susceptibility, and understanding the resistance mechanism of this important genus, our knowledge in these areas remains fragmentary and incomplete. In this study, we aimed to address these gaps by investigating promising identification methods, the antimicrobial susceptibility patterns, and a novel quinolone resistance mechanism in species, utilizing a collection of clinical isolates. The findings of our study will contribute to improve diagnosis and successful management of infections caused by species, as well as establishing well-defined performance and interpretive criteria for antimicrobial susceptibility testing.

摘要

该物种在临床上被认为是罕见但新兴的机会性病原体,可导致人类各种感染。由于其临床表现类似于结核病样综合征,肺炎常被误诊为肺结核。该物种在实验室中也与其他系统发育细菌混淆,如。本研究旨在探讨种的临床、微生物学和分子特征;物种分布;以及对种的抗菌敏感性。免疫缺陷和慢性肺部疾病似乎是肺炎的危险因素,影像学上存在支气管扩张和肺结节与这种感染高度相关。研究证实,(热休克蛋白 60)和(分泌 ATP 酶)基因是鉴定种的可靠工具。此外,(稳定的小 RNA)基因作为区分不同种的工具具有很大的潜力,其序列长度最短。就抗菌敏感性而言,喹诺酮类、甲氧苄啶/磺胺甲恶唑、阿米卡星、米诺环素、利奈唑胺和替加环素对本研究中的种分离株表现出强大的活性。该研究还提出了一种涉及喹诺酮类药物耐药决定区基因内取代(S91R)的耐药机制,该取代赋予了对左氧氟沙星和环丙沙星的耐药性。此外,我们发现纸片扩散试验不适合测试种分离株对环丙沙星、亚胺培南和米诺环素的敏感性。总之,我们的系统研究可能有助于更好地了解这种罕见的病原体。种是罕见但新兴的人类病原体,与放线菌目中其他含有分枝菌酸的属有显著相似性,特别是。因此,在临床环境中可能会发生误诊和治疗失败。尽管准确识别、抗菌敏感性和了解这个重要属的耐药机制意义重大,但我们在这些领域的知识仍然是零碎和不完整的。在这项研究中,我们旨在通过调查有前途的鉴定方法、种的抗菌敏感性模式和种中新型喹诺酮类耐药机制,利用临床分离株来解决这些差距。我们的研究结果将有助于改善对种引起的感染的诊断和成功管理,并为抗菌药物敏感性测试建立明确的性能和解释标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc24/10715089/1ba056f7a75c/spectrum.01644-23.f001.jpg

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