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埃塞俄比亚转诊医院脓毒症患者中鉴定出的新发病原体的基因组特征分析。

Genomic characterizations of emerging pathogens identified from sepsis patients in Ethiopian referral hospitals.

作者信息

Legese Melese Hailu, Asrat Daniel, Mihret Adane, Hasan Badrul, Aseffa Abraham, Swedberg Göte

机构信息

Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

出版信息

Emerg Microbes Infect. 2025 Dec;14(1):2440494. doi: 10.1080/22221751.2024.2440494. Epub 2024 Dec 18.

Abstract

Healthcare in low- and middle-income countries is becoming problematic due to the emergence of multidrug-resistant bacteria causing serious morbidity and mortality. carrying multiple antimicrobial resistance (AMR) genes were found significantly among sepsis patients in a study done between October 2019 and September 2020 at four Ethiopian hospitals located in the central (Tikur Anbessa and Yekatit 12), southern (Hawassa), and northern (Dessie) parts. Among 1416 sepsis patients, 74  isolates were identified using MALDI-TOF, most of them at Dessie ( = 44) and Hawassa ( = 28) hospitals. Whole genome sequencing showed that strains identified at Dessie Hospital displayed phylogenetic clonality, carried an IncM1 plasmid and the majority were ST3924. Many identified at Hawassa Hospital were clonally clustered and the majority belonged to novel STs and carried IncFIB(K) and IncFII(K) plasmids concurrently. Fifty carried ESBL genes while 2 isolates harboured AmpC. Other frequently found genes were , , , , , , , and . Virulence genes detected at both sites were for biofilm formation and siderophore ABC transporter operons for iron uptake. Capsular alleles varied, with at Dessie and at Hawassa. The isolation of multidrug-resistant as an emerging sepsis pathogen calls for strong infection prevention strategies and antimicrobial stewardship supported by advanced bacterial identification techniques.

摘要

由于多重耐药细菌的出现导致严重的发病率和死亡率,低收入和中等收入国家的医疗保健正面临问题。在2019年10月至2020年9月期间于埃塞俄比亚位于中部(提古雷·安贝萨和耶卡蒂特12医院)、南部(哈瓦萨)和北部(德西)的四家医院进行的一项研究中,在脓毒症患者中显著发现了携带多种抗菌药物耐药性(AMR)基因的情况。在1416名脓毒症患者中,使用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)鉴定出74株菌株,其中大多数来自德西(n = 44)和哈瓦萨(n = 28)医院。全基因组测序表明,在德西医院鉴定出的菌株显示出系统发育克隆性,携带IncM1质粒,且大多数为ST3924。在哈瓦萨医院鉴定出的许多菌株呈克隆聚集,大多数属于新的序列类型(STs),并同时携带IncFIB(K)和IncFII(K)质粒。50株携带超广谱β-内酰胺酶(ESBL)基因,而2株携带AmpC基因。其他经常发现的基因有blaCTX-M、blaTEM、blaSHV、mcr-1、mcr-2、mcr-3、qnrS、qnrB和armA。在两个地点检测到的毒力基因是用于生物膜形成的csuE和用于铁摄取的铁载体ABC转运操纵子。荚膜等位基因各不相同,德西为K1,哈瓦萨为K2。作为一种新兴的脓毒症病原体,多重耐药肺炎克雷伯菌的分离需要强有力的感染预防策略以及由先进细菌鉴定技术支持的抗菌药物管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f337/11656759/972e0f2c0794/TEMI_A_2440494_F0001_OC.jpg

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