Le Huyen Thanh Thi, Hoang Trang Thu, Nguyen Ngoc Anh Thi, Nguyen Sang Ngoc, Nguyen Ung Dinh, Hoang Cuong Xuan, Vo Nam S, Le Duc Quang, Nguyen Son Hoang, Cao Minh Duc, Ho Tho Huu
Department of Pediatrics, Faculty of Clinical Internal Medicine, Vinh Medical University, Vinh 431000, Vietnam.
Department of Genomics, Institute of Biomedicine & Pharmacy (IBP), Vietnam Military Medical University, Hanoi 10000, Vietnam.
Antibiotics (Basel). 2024 Sep 2;13(9):830. doi: 10.3390/antibiotics13090830.
(1) Background: Pediatric urinary tract infections (UTIs) pose significant challenges due to drug-resistant () strains. This study utilizes whole-genome sequencing to analyze temporal trends in antibiotic resistance genes (ARGs) in clinical isolates from pediatric UTI cases in central Vietnam. (2) Methods: We conducted whole-genome sequencing on 71 isolates collected from pediatric UTI patients between 2018 and 2020. ARGs were identified, and their prevalence over time was analyzed. Statistical tests were used to correlate ARG presence with antibiotic resistance. (3) Results: Of the 47 isolates with complete data, 40 distinct ARGs were identified, with a median of 10 resistance genes per isolate. A significant increase in the total number of ARGs per isolate was observed over time, from an average of 8.88 before June 2019 to 11.63 after. Notably, the prevalence of the gene (aminoglycoside resistance) rose from 0% to 26.7%, and that of the gene (beta-lactam and carbapenem resistance) increased from 0% to 23.3%. Key correlations include blaEC with cephalosporin resistance, with carbapenem resistance, and with sulfamethoxazole/trimethoprim resistance. (4) Conclusions: Whole-genome sequencing reveals complex and evolving antibiotic resistance patterns in pediatric UTIs in central Vietnam, with a marked increase in ARG prevalence over time. Continuous surveillance and targeted treatments are essential to address these trends. Understanding genetic foundations is crucial for effective intervention strategies.
(1) 背景：由于耐药菌株的存在，小儿尿路感染（UTIs）带来了重大挑战。本研究利用全基因组测序分析越南中部小儿UTI临床分离株中抗生素耐药基因（ARGs）的时间趋势。(2) 方法：我们对2018年至2020年期间从小儿UTI患者中收集的71株分离株进行了全基因组测序。鉴定了ARGs，并分析了它们随时间的流行情况。使用统计测试将ARG的存在与抗生素耐药性相关联。(3) 结果：在47株有完整数据的分离株中，鉴定出40种不同的ARGs，每株分离株中耐药基因的中位数为10个。随着时间的推移，观察到每株分离株中ARG总数显著增加，从2019年6月前的平均8.88个增加到之后的11.63个。值得注意的是，aac(6′)-Ib-cr基因（氨基糖苷类耐药）的流行率从0%上升到26.7%，blaNDM-1基因（β-内酰胺和碳青霉烯类耐药）的流行率从0%增加到23.3%。关键的相关性包括blaEC与头孢菌素耐药性、blaNDM-1与碳青霉烯类耐药性以及sul2与磺胺甲恶唑/甲氧苄啶耐药性。(4) 结论：全基因组测序揭示了越南中部小儿UTIs中复杂且不断演变的抗生素耐药模式，随着时间的推移，ARG流行率显著增加。持续监测和针对性治疗对于应对这些趋势至关重要。了解遗传基础对于有效的干预策略至关重要。
