Dashti Ali A, Vali Leila, Shamsah Sara, Jadaon Mehrez, ElShazly Sherief
Department of Medical Laboratory Sciences, Health Sciences Center, Faculty of Allied Health Sciences, Kuwait University, Kuwait.
School of Education and Applied Science, University of Gloucestershire, Cheltenham, UK.
Iran J Pharm Res. 2024 Mar 9;23(1):e143910. doi: 10.5812/ijpr-143910. eCollection 2024 Jan-Dec.
Antibiotic-resistant is one of the major opportunistic pathogens that cause hospital-acquired infections worldwide. These infections include catheter-associated urinary tract infections (UTIs), ventilator-associated pneumonia, surgical wound infections, and bacteraemia.
To understand the mechanisms of resistance and prevent its spread, we studied C91 (ST38), a clinical outbreak strain that was extensively drug-resistant. The strain was isolated from an intensive care unit (ICU) in one of Kuwait's largest hospitals from a patient with UTI.
This study used whole-genome sequencing (Illumina, MiSeq) to identify the strain's multi-locus sequence type, resistance genes (ResFinder), and virulence factors. This study also measured the minimum inhibitory concentrations (MIC) of a panel of antibiotics against this isolate.
The analysis showed that C-91 was identified as O99 H30 ST38 and was resistant to all antibiotics tested, including colistin (MIC > 32 mg/L). It also showed intermediate resistance to imipenem and meropenem (MIC = 8 mg/L). Genome analysis revealed various acquired resistance genes, including -1, , , and . However, we did not detect or . There were also several point mutations resulting in amino acid changes in chromosomal genes: A, C, B, and C promoter. Additionally, we detected several multidrug efflux pumps, including the multidrug efflux pump (A). Eleven prophage regions were identified, and PHAGE_Entero_SfI_NC was detected to contain ISEc46 and ethidium multidrug resistance protein E (E), a small multidrug resistance (SMR) protein family. Finally, there was an abundance of virulence factors in this isolate, including fimbriae, biofilm, and capsule formation genes.
This isolate has a diverse portfolio of antimicrobial resistance and virulence genes and belongs to ST38 O99 H30, posing a serious challenge to treating infected patients in clinical settings.
耐抗生素菌是全球范围内引起医院获得性感染的主要机会性病原体之一。这些感染包括导管相关尿路感染（UTI）、呼吸机相关性肺炎、手术伤口感染和菌血症。
为了解耐药机制并防止其传播，我们研究了C91（ST38），这是一株广泛耐药的临床暴发菌株。该菌株从科威特最大医院之一的重症监护病房（ICU）的一名UTI患者中分离得到。
本研究使用全基因组测序（Illumina，MiSeq）来鉴定该菌株的多位点序列类型、耐药基因（ResFinder）和毒力因子。本研究还测定了一组抗生素对该分离株的最低抑菌浓度（MIC）。
分析表明，C-91被鉴定为O99 H30 ST38，对所有测试抗生素耐药，包括黏菌素（MIC>32mg/L）。它对亚胺培南和美罗培南也表现出中度耐药（MIC = 8mg/L）。基因组分析揭示了各种获得性耐药基因，包括-1、、、和。然而，我们未检测到或。染色体基因中也有几个导致氨基酸变化的点突变：A、C、B和C启动子。此外，我们检测到几个多药外排泵，包括多药外排泵（A）。鉴定出11个前噬菌体区域，检测到PHAGE_Entero_SfI_NC包含ISEc46和乙锭多药耐药蛋白E（E），一个小多药耐药（SMR）蛋白家族。最后，该分离株中有大量毒力因子，包括菌毛、生物膜和荚膜形成基因。
该分离株具有多种抗菌耐药性和毒力基因组合，属于ST38 O99 H30，给临床环境中感染患者的治疗带来了严峻挑战。
