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从坦桑尼亚地区转诊医院就诊患者中分离的耐甲氧西林金黄色葡萄球菌的基因组特征。

Genomic characterization of methicillin-resistant Staphylococcus aureus isolated from patients attending regional referral hospitals in Tanzania.

机构信息

Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.

Kilimanjaro Clinical Research Institute, Kilimanjaro, Tanzania.

出版信息

BMC Med Genomics. 2024 Aug 14;17(1):211. doi: 10.1186/s12920-024-01979-4.

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) colonization increases the risk of subsequent infection by MRSA strain complex interlinking between hospital and community-acquired MRSA which increases the chance of drug resistance and severity of the disease.

OBJECTIVE

Genomic characterization of Staphylococcus aures strains isolated from patients attending regional referral hospitals in Tanzania.

METHODOLOGY

A laboratory-based cross-sectional study using short read-based sequencing technology, (Nextseq550,Illumina, Inc. San diego, California, USA). The samples used were collected from patients attending selected regional referral hospitals in Tanzania under the SeqAfrica project. Sequences were analyzed using tools available in the center for genomic and epidemiology server, and visualization of the phylogenetic tree was performed in ITOL 6.0. SPSS 28.0 was used for statistical analysis.

RESULTS

Among 103 sequences of S. aureus, 48.5% (50/103) carry the mecA gene for MRSA. High proportions of MRSA were observed among participants aged between 18 and 34 years (52.4%), in females (54.3%), and among outpatients (60.5%). The majority of observed MRSA carried plasmids rep5a (92.0%), rep16 (90.0%), rep7c (90.0%), rep15 (82.0%), rep19 (80.0%) and rep10 (72.0%). Among all plasmids observed rep5a, rep16, rep20, and repUS70 carried the blaZ gene, rep10 carried the erm(C) gene and rep7a carried the tet(K) gene. MLST and phylogeny analysis reveal high diversity among MRSA. Six different clones were observed circulating at selected regional hospitals and MRSA with ST8 was dominant.

CONCLUSION

The study reveals a significant presence of MRSA in Staphylococcus aureus strains from Tanzanian regional hospitals, with nearly half carrying the mecA gene. MRSA is notably prevalent among young adults, females, and outpatients, showing high genetic diversity and dominance of ST8. Various plasmids carrying resistance genes indicate a complex resistance profile, highlighting the need for targeted interventions to manage MRSA infections in Tanzania.

摘要

背景

耐甲氧西林金黄色葡萄球菌(MRSA)定植会增加随后感染医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)和社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)复合菌株的风险,这会增加耐药性和疾病严重程度的机会。

目的

对来自坦桑尼亚地区转诊医院患者的金黄色葡萄球菌菌株进行基因组特征分析。

方法

这是一项基于实验室的横断面研究,使用基于短读序列的测序技术(Nextseq550,Illumina,Inc.,加利福尼亚州圣地亚哥)。该研究使用的样本是在 SeqAfrica 项目下从坦桑尼亚选定的地区转诊医院的患者中收集的。使用基因组和流行病学中心提供的工具对序列进行分析,并在 ITOL 6.0 中进行系统发育树的可视化。使用 SPSS 28.0 进行统计分析。

结果

在 103 株金黄色葡萄球菌序列中,48.5%(50/103)携带 mecA 基因,表明存在耐甲氧西林金黄色葡萄球菌。18 至 34 岁(52.4%)、女性(54.3%)和门诊患者(60.5%)中观察到的耐甲氧西林金黄色葡萄球菌比例较高。观察到的大多数耐甲氧西林金黄色葡萄球菌携带质粒 rep5a(92.0%)、rep16(90.0%)、rep7c(90.0%)、rep15(82.0%)、rep19(80.0%)和 rep10(72.0%)。在观察到的所有质粒中,rep5a、rep16、rep20 和 repUS70 携带 blaZ 基因,rep10 携带 erm(C) 基因,rep7a 携带 tet(K) 基因。多位点序列分型和系统发育分析显示,耐甲氧西林金黄色葡萄球菌存在高度多样性。在选定的地区医院观察到 6 种不同的克隆在循环,ST8 是优势克隆。

结论

本研究揭示了坦桑尼亚地区医院金黄色葡萄球菌中存在显著的耐甲氧西林金黄色葡萄球菌,近一半携带 mecA 基因。耐甲氧西林金黄色葡萄球菌在年轻成年人、女性和门诊患者中尤为普遍,表现出高度的遗传多样性和 ST8 的优势。携带耐药基因的各种质粒表明存在复杂的耐药谱,这突显了在坦桑尼亚需要针对耐甲氧西林金黄色葡萄球菌感染进行有针对性的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3d3/11323609/719c2b6c661a/12920_2024_1979_Fig1_HTML.jpg

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