Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China.
Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, China; Nanjing Field Epidemiology Training Program, Nanjing Municipal Center for Disease Control and Prevention, China.
Microb Pathog. 2024 Nov;196:106996. doi: 10.1016/j.micpath.2024.106996. Epub 2024 Oct 3.
To investigate the distribution of carbapenem-resistant Enterobacterales (CRE) in the community and to describe the genomic characteristics.
CRE screened from fecal samples in healthy people at the health examination center of a tertiary hospital in China underwent Whole genome sequencing (WGS) to analyze genotypic characteristics of CRE. The flanking DNA sequence of blaNDM-5 and mcr1.1 genes were analyzed by Gcluster software.
A total of 7187 fecal samples were screened, and CRE carriage was detected in 0.4 % of the sampled population. In total, 30 Escherichia coli, one Citrobacter freundii and one Klebsiella aerogene were screened. The 30 carbapenem-resistant Escherichia coli (CREC) isolates displayed slight resistance to amikacin (13.3 %) and aztreonam (20.0 %). All the CRE isolates contained blaNDM, and blaNDM-5 (84.4 %) was the most common one. B1 (n = 11) and A (n = 7) were predominant phylogroups. Furthermore, 34 distinct plasmid replicons, 67 different VFs, 22 distinct STs, 17 different FimH types, 26 O:H serotypes as well as 74 MGEs including 61 insertion sequences and 13 transposons were identified. The flanking DNA sequence analysis of blaNDM-5 and mcr1.1 genes indicates the key role of horizontal transfer of blaNDM-5 in the CRE development evidenced by diverse STs and phylogenetic tree.
E. coli was the most predominant CRE isolates in community setting, and blaNDM (blaNDM-5) was the main CHβL encoding genes. The high prevalence of ARGs was associated with high resistance to commonly used antimicrobials. Besides, the genetic diversity of these isolates suggested the key role of blaNDM horizontal transfer in the CRE development. Thus, active screening of blaNDM in communities is particularly important for the prevention and control of CRE.
研究社区中产碳青霉烯酶肠杆菌科（CRE）的分布，并描述其基因组特征。
对中国一家三甲医院体检中心健康人群粪便样本中筛选出的 CRE 进行全基因组测序（WGS），分析 CRE 的基因型特征。使用 Gcluster 软件分析 blaNDM-5 和 mcr1.1 基因的侧翼 DNA 序列。
共筛选了 7187 份粪便样本，检出 0.4%的人群携带 CRE。共筛选出 30 株大肠埃希菌、1 株弗氏柠檬酸杆菌和 1 株产气肠杆菌。30 株耐碳青霉烯大肠埃希菌（CREC）对阿米卡星（13.3%）和氨曲南（20.0%）略有耐药。所有 CRE 分离株均携带 blaNDM，其中 blaNDM-5（84.4%）最为常见。B1（n=11）和 A（n=7）为主要的菌系。此外，还鉴定出 34 种不同的质粒复制子、67 种不同的 VF、22 种不同的 ST、17 种不同的 FimH 型、26 种 O:H 血清型以及 74 种 MGEs，包括 61 种插入序列和 13 种转座子。blaNDM-5 和 mcr1.1 基因侧翼 DNA 序列分析表明，blaNDM-5 的水平转移在 CRE 发展中起关键作用，这从不同的 ST 和系统发育树中可以看出。
社区中产 CRE 的最主要的分离株是大肠埃希菌，主要的 CHβL 编码基因是 blaNDM（blaNDM-5）。这些分离株对抗生素的高耐药性与 ARGs 的高流行率有关。此外，这些分离株的遗传多样性表明 blaNDM 的水平转移在 CRE 的发展中起关键作用。因此，社区中积极筛查 blaNDM 对 CRE 的防控尤为重要。
