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在中国儿童感染中呈阳性出现。

Emerging -positive in Chinese pediatric infections.

作者信息

Ke Yefang, Zhu Zhe, Lu Wenbo, Liu Wenyuan, Ye Lina, Jia Chenghao, Yue Min

机构信息

Department of Clinical Laboratory, Women and Children's Hospital of Ningbo University, Ningbo, China.

Ningbo Key Laboratory for the Prevention and Treatment of Embryogenic Diseases, Women and Children's Hospital of Ningbo University, Ningbo, China.

出版信息

Microbiol Spectr. 2024 Oct 18;12(12):e0148524. doi: 10.1128/spectrum.01485-24.

Abstract

Non-typhoidal (NTS) is a common zoonotic foodborne pathogen, whose rising antimicrobial resistance has been an urgent threat to global public health. Here, we reported two carbapenem-resistant (CRSE) strains (NBFE-049 and NBFE-164) carrying the genes, which were recovered from two Chinese children, belonged to serovar Typhimurium (. Typhimurium) monophasic variant (. 1,4,[5],12:i:-) ST34 (a sequence type) and . Typhimurium ST19, respectively. Genes and were detected in NBFE-049 and NBFE-164, respectively. The in NBFE-049 was located in an IncHI2-type plasmid, named pNBFE-049. In NBFE-164, the was located in an IncI1-type plasmid, named pNBFE-164. The plasmid pNBFE-164 successfully transferred its resistance phenotype into the recipient strain J53 with a high efficiency of 1.1 × 10, while no transconjugants were obtained in pNBFE-049 conjugation assays. We further elucidated the genetic relationships of globally occurring New Delhi Metallo-β-lactamase (NDM)-positive strains and locally distributed clinical strains within the same serovar. The closest relative of NBFE-049 was clinical strain 1722, which was recovered in 2020 and differed by only three Single Nucleotide Polymorphisms (SNPs). No NDM-positive ST19 could be found in the National Center for Biotechnology Information (NCBI) database, and NBFE-164 showed a close genetic relationship with the other ST19 in this area. To sum up, we suggested the potential contributions of clonal spread and plasmid-mediated transfer in CRSE dissemination. This study reported the complete genome of two -carrying . Typhimurium isolates, shedding new insights into the antimicrobial resistance mechanisms and dissemination patterns of the emerging CRSE.IMPORTANCENTS is one of the most common zoonotic pathogens that causes foodborne illnesses, while . Typhimurium is one of the most common serovars. With the rising prevalence of multi-resistant worldwide, carbapenems have emerged as the last-line antibiotics for treating severe bacterial infections. In this study, we reported the genomic characteristics of two carbapenem-resistant . Typhimurium strains, which were recovered from two pediatric patients, carrying and , providing new insights into the antimicrobial resistance deteriminants and transmission risk of -positive NTS in China. We suggested the potential contributions of clonal spread and plasmid-mediated transfer in CRSE dissemination. Future enhanced surveillance policy should mitigate CRSE spreading, and more importantly, clinical antimicrobial therapeutic regimens should be adjusted accordingly.

摘要

非伤寒沙门氏菌(NTS)是一种常见的人畜共患食源性病原体,其日益增强的抗菌药物耐药性已成为全球公共卫生的紧迫威胁。在此,我们报告了两株携带 blaNDM 基因的耐碳青霉烯类(CRSE)菌株(NBFE - 049 和 NBFE - 164),它们分别从两名中国儿童中分离得到,分别属于鼠伤寒沙门氏菌(Salmonella Typhimurium)单相变体(Salmonella 1,4,[5],12:i:-)ST34(一种序列型)和鼠伤寒沙门氏菌 ST19。blaNDM - 1 和 blaNDM - 5 基因分别在 NBFE - 049 和 NBFE - 164 中被检测到。NBFE - 049 中的 blaNDM - 1 位于一个 IncHI2 型质粒上,命名为 pNBFE - 049。在 NBFE - 164 中,blaNDM - 5 位于一个 IncI1 型质粒上,命名为 pNBFE - 164。质粒 pNBFE - 164 以 1.1×10⁻³ 的高效率成功将其耐药表型转移到受体菌株 J53 中,而在 pNBFE - 049 的接合试验中未获得接合子。我们进一步阐明了全球范围内出现的新德里金属β - 内酰胺酶(NDM)阳性菌株与同一血清型内局部分布的临床菌株之间的遗传关系。NBFE - 049 最相近的亲缘菌株是临床菌株 1722,该菌株于 2020 年分离得到,仅相差三个单核苷酸多态性(SNP)。在国家生物技术信息中心(NCBI)数据库中未发现 NDM 阳性的 ST19,并且 NBFE - 164 与该地区的其他 ST19 显示出密切的遗传关系。综上所述,我们提出了克隆传播和质粒介导的 blaNDM 转移在 CRSE 传播中的潜在作用。本研究报告了两株携带 blaNDM 的鼠伤寒沙门氏菌分离株的完整基因组,为新兴 CRSE 的抗菌药物耐药机制和传播模式提供了新的见解。

重要性

NTS 是引起食源性疾病的最常见人畜共患病原体之一,而鼠伤寒沙门氏菌是最常见的血清型之一。随着全球多重耐药 NTS 的患病率上升,碳青霉烯类已成为治疗严重细菌感染的最后一线抗生素。在本研究中,我们报告了两株耐碳青霉烯类鼠伤寒沙门氏菌菌株的基因组特征,它们从两名儿科患者中分离得到,携带 blaNDM - 1 和 blaNDM - 5,为中国 NDM 阳性 NTS 的抗菌药物耐药决定因素和传播风险提供了新的见解。我们提出了克隆传播和质粒介导的 blaNDM 转移在 CRSE 传播中的潜在作用。未来加强监测政策应减轻 CRSE 的传播,更重要的是,临床抗菌治疗方案应相应调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1293/11619303/7d4d25ee10af/spectrum.01485-24.f001.jpg

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