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2021 年 3 月至 8 月，荷兰发生携带 blaNDM-1、blaCTX-M-15 和 mcr-1 的 导致对依拉环素和奥马环素耐药的 医院感染。

Nosocomial transmission of , and -carrying conferring resistance to eravacycline and omadacycline, the Netherlands, March to August 2021.

机构信息

Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Medical Microbiology, Rivierenland Ziekenhuis, Tiel, The Netherlands.

出版信息

Euro Surveill. 2024 Jul;29(28). doi: 10.2807/1560-7917.ES.2024.29.28.2400019.

DOI:10.2807/1560-7917.ES.2024.29.28.2400019
PMID:38994602
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11241855/
Abstract

Carbapenem-resistant (CRAb) is an important pathogen causing serious nosocomial infections. We describe an outbreak of CRAb in an intensive care unit in the Netherlands in 2021. During an outbreak of non-resistant , while infection control measures were in place, CRAb isolates carrying highly similar and encoding plasmids were isolated from three patients over a period of several months. The chromosomal and plasmid sequences of the CRAb and non-carbapenemase-carrying isolates cultured from patient materials were analysed using hybrid assemblies of short-read and long-read sequences. The CRAb isolates revealed that the CRAb outbreak consisted of two different strains, carrying similar plasmids. The plasmids contained multiple antibiotic resistance genes including the tetracycline resistance gene , and the and carbapenemase genes. We determined minimal inhibitory concentrations (MICs) for 13 antibiotics, including the newly registered tetracycline antibiotics eravacycline and omadacycline. The CRAb isolates showed high MICs for tetracycline antibiotics including eravacycline and omadacycline, except for minocycline which had a low MIC. In this study we show the value of sequencing multidrug-resistant for outbreak tracking and guiding outbreak mitigation measures.

摘要

耐碳青霉烯类抗生素（CRAb）是一种重要的病原体，可导致严重的医院感染。我们描述了 2021 年荷兰一家重症监护病房发生的耐碳青霉烯类抗生素细菌爆发事件。在非耐药菌爆发期间，尽管采取了感染控制措施，但在数月的时间里，仍从 3 名患者身上分离出了携带高度相似 blaNDM-1 和编码质粒的耐碳青霉烯类抗生素细菌分离株。使用短读长和长读长序列的混合组装，对来自患者样本的耐碳青霉烯类抗生素和不携带碳青霉烯酶细菌分离株的染色体和质粒序列进行了分析。耐碳青霉烯类抗生素分离株表明，耐碳青霉烯类抗生素的爆发由两种不同的菌株组成，携带相似的质粒。这些质粒包含多种抗生素耐药基因，包括四环素耐药基因 tet(A) 和 blaNDM-1 碳青霉烯酶基因。我们测定了 13 种抗生素的最小抑菌浓度（MIC），包括新注册的四环素类抗生素依拉环素和奥马环素。耐碳青霉烯类抗生素分离株对包括依拉环素和奥马环素在内的四环素类抗生素表现出较高的 MIC 值，除了米诺环素外，其 MIC 值较低。在这项研究中，我们展示了对多药耐药菌进行测序以追踪疫情爆发和指导疫情缓解措施的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/7162f8fffedd/2400019-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/08108769a1a3/2400019-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/476e52382f8a/2400019-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/7162f8fffedd/2400019-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/08108769a1a3/2400019-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/476e52382f8a/2400019-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a64/11241855/7162f8fffedd/2400019-f3.jpg

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