Cummings School of Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, T2L 2K8, Canada.
Alberta Precision Laboratories, Calgary, Alberta, Canada.
Eur J Clin Microbiol Infect Dis. 2024 Mar;43(3):501-510. doi: 10.1007/s10096-024-04750-w. Epub 2024 Jan 10.
Population-based surveillance was undertaken to determine clinical factors, susceptibility patterns, and incidence rates (IR) of Pseudomonas aeruginosa causing bloodstream infections (BSIs) in a Canadian region (2010-2018).
We combined clinical data with genomics to characterize P. aeruginosa (BSIs) (n = 167) in a well-defined Canadian (Calgary) human population over a 9-year period (2010-2018).
The annual population IR per 100,000 patient years increased from 3.4/100,000 in 2010 to 5.9/100,000 in 2018, with the highest IRs in elderly males from the hospital setting. Over a quarter of patients presented with febrile neutropenia, followed by urinary tract infections and pneumonia. Antimicrobial resistance (AMR) rates and determinants were rare. The P. aeruginosa population was polyclonal consisting of three dominant sequence types (STs), namely ST244, ST111, and ST17. Antimicrobial-susceptible ST244 was the most common clone and belonged to three clades (A, B, C). The ST244 IR/100,000 increased over time due to the expansion of clade C. Multidrug-resistant ST111 was the second most common clone and IR/100,000 decreased over time. ST111 belonged to three clades (A, B, C) with clade C containing bla. Different serotypes were linked to various STs. The IR/100,000 of P. aeruginosa that belonged to serotypes O6 increased significantly over time.
An effective multivalent vaccine consisting of five serotypes (O1, O3, O5, O6, O11) would confer protection to > 70% of Calgary residents with P. aeruginosa BSIs. This study has provided a unique perspective of the population dynamics over time of P. aeruginosa STs, clades, and serotypes responsible for BSIs.
开展基于人群的监测，以确定在加拿大某一地区（2010-2018 年）导致血流感染（BSI）的铜绿假单胞菌的临床因素、易感性模式和发病率（IR）。
我们将临床数据与基因组学相结合，对在 9 年期间（2010-2018 年）明确界定的加拿大（卡尔加里）人群中由铜绿假单胞菌引起的 BSI（n=167）进行了特征描述。
每年每 10 万患者年的人口 IR 从 2010 年的 3.4/100,000 增加到 2018 年的 5.9/100,000，其中来自医院环境的老年男性的 IR 最高。超过四分之一的患者表现为发热性中性粒细胞减少症，其次是尿路感染和肺炎。抗菌药物耐药（AMR）率和决定因素很少见。铜绿假单胞菌群体是多克隆的，由三个主要序列型（ST）组成，即 ST244、ST111 和 ST17。抗菌药物敏感的 ST244 是最常见的克隆，属于三个分支（A、B、C）。由于 clade C 的扩展，ST244 的 IR/100,000 随着时间的推移而增加。多药耐药性 ST111 是第二常见的克隆，IR/100,000 随着时间的推移而减少。ST111 属于三个分支（A、B、C），其中分支 C 含有 bla。不同的血清型与不同的 ST 相关。属于血清型 O6 的铜绿假单胞菌的 IR/100,000 随着时间的推移显著增加。
由五个血清型（O1、O3、O5、O6、O11）组成的有效多价疫苗将为 70%以上的因铜绿假单胞菌 BSI 而遭受感染的卡尔加里居民提供保护。本研究提供了一个独特的视角，了解了不同时间导致血流感染的铜绿假单胞菌 ST、分支和血清型的人群动态。
