替加环素的临床应用可能导致碳青霉烯类耐药高毒力菌株的广泛传播。
Clinical use of tigecycline may contribute to the widespread dissemination of carbapenem-resistant hypervirulent strains.
机构信息
Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong.
Department of Food Science and Nutrition, Faculty of Science, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
出版信息
Emerg Microbes Infect. 2024 Dec;13(1):2306957. doi: 10.1080/22221751.2024.2306957. Epub 2024 Jan 30.
The emergence of carbapenem-resistant hypervirulent (CR-hvKP) poses grave threats to human health. These strains increased dramatically in clinical settings in China in the past few years but not in other parts of the world. Four isogenic strains, including classical , carbapenem-resistant (CRKP), hypervirulent (hvKP) and CR-hvKP, were created and subjected to phenotypic characterization, competition assays, mouse sepsis model and rat colonization tests to investigate the mechanisms underlying the widespread nature of CR-hvKP in China. Acquisition of virulence plasmid led to reduced fitness and abolishment of colonization in the gastrointestinal tract, which may explain why hvKP is not clinically prevalent after its emergence for a long time. However, tigecycline treatment facilitated the colonization of hvKP and CR-hvKP and reduced the population of spp. in animal gut microbiome. Feeding with spp. could significantly reduce the colonization of hvKP and CR-hvKP in the animal gastrointestinal tract. Our data implied that the clinical use of tigecycline to treat carbapenem-resistant infections facilitated the high spread of CR-hvKP in clinical settings in China and demonstrated that spp was a potential candidate for anticolonization strategy against CR-hvKP.
产碳青霉烯酶高毒力 (CR-hvKP) 的出现对人类健康构成严重威胁。这些菌株在过去几年中在中国的临床环境中急剧增加,但在世界其他地区没有增加。我们创建了四个同源菌株,包括经典型、耐碳青霉烯(CRKP)、高毒力(hvKP)和 CR-hvKP,对它们进行表型特征描述、竞争实验、小鼠败血症模型和大鼠定植实验,以研究 CR-hvKP 在我国广泛传播的机制。毒力质粒的获得导致适应性降低,并消除了胃肠道的定植,这可能解释了为什么 hvKP 在出现很长时间后并没有在临床上普遍流行。然而,替加环素治疗促进了 hvKP 和 CR-hvKP 的定植,并减少了 spp 在动物肠道微生物组中的种群。喂食 spp. 可显著减少动物胃肠道中 hvKP 和 CR-hvKP 的定植。我们的数据表明,替加环素治疗耐碳青霉烯类感染的临床应用促进了 CR-hvKP 在我国临床环境中的高度传播,并表明 spp. 是针对 CR-hvKP 的定植抑制策略的潜在候选者。