Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Paediatric Pulmonology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Pediatr Pulmonol. 2024 Dec;59(12):3340-3348. doi: 10.1002/ppul.27202. Epub 2024 Aug 7.
Pseudomonas aeruginosa AUST-03 (ST242) has been reported to cause epidemics in people with CF (pwCF) from Australia and has been associated with multidrug resistance and increased morbidity and mortality. Here, we report an epidemic P. aeruginosa (AUST-03) strain in South African pwCF detected at a public hospital and characterize the genomic antibiotic resistance determinants.
The P. aeruginosa AUST-03 (ST242) study isolates were analysed with whole genome sequencing using the Illumina NextSeq2000 platform. Raw sequencing reads were processed using the Jekesa pipeline and multilocus sequence typing and genomic antibiotic resistance characterization was performed using public databases. Genetic relatedness between the study isolates and global P. aeruginosa ST242 from public databases was determined using a maximum-likelihood phylogenetic tree. Antibiotic susceptibility testing was performed using the disk diffusion and broth microdilution techniques.
A total of 11 P. aeruginosa AUST-03 isolates were isolated from two children with CF. The majority (8/11) of these isolates were multidrug-resistant (MDR) or extensively drug resistant; and the multidrug efflux pumps MexAB-OprM, MexCD-OprJ, MexEF-OprN, and MexXY-OprM were the most clinically relevant antibiotic resistance determinants and were detected in all of the isolates. The study isolates were the most closely related to a 2020 P. aeruginosa AUST-03 (ST242) CF isolate from Russia.
Epidemic MDR P. aeruginosa strains are present at South African public CF clinics and need to be considered when implementing segregation and infection control strategies to prevent possible spread and outbreaks.
铜绿假单胞菌 AUST-03（ST242）已被报道在来自澳大利亚的 CF（肺囊性纤维化）患者中引发流行，并与多药耐药性以及发病率和死亡率增加有关。在这里，我们报告了在南非公立医院发现的流行铜绿假单胞菌（AUST-03）菌株，并对其基因组抗生素耐药决定因素进行了特征描述。
使用 Illumina NextSeq2000 平台对铜绿假单胞菌 AUST-03（ST242）研究分离株进行全基因组测序分析。使用 Jekesa 管道处理原始测序读数，并使用公共数据库进行多位点序列分型和基因组抗生素耐药特征分析。使用最大似然系统发育树确定研究分离株与来自公共数据库的全球铜绿假单胞菌 ST242 之间的遗传相关性。使用纸片扩散和肉汤微量稀释技术进行抗生素药敏试验。
从两名 CF 儿童中分离出 11 株铜绿假单胞菌 AUST-03 分离株。这些分离株中的大多数（8/11）为多药耐药（MDR）或广泛耐药（XDR）；并且多药外排泵 MexAB-OprM、MexCD-OprJ、MexEF-OprN 和 MexXY-OprM 是最具临床相关性的抗生素耐药决定因素，在所有分离株中均检测到。研究分离株与 2020 年来自俄罗斯的一株铜绿假单胞菌 AUST-03（ST242）CF 分离株最为密切相关。
流行的 MDR 铜绿假单胞菌菌株存在于南非公立 CF 诊所中，在实施隔离和感染控制策略以防止可能的传播和暴发时需要加以考虑。
