Shahari Aisyah Syakirah, Palanisamy Navindra Kumari, Mohd Nor Fadzilah
Institute for Medical Molecular Biotechnology (IMMB), Faculty of Medicine, Universiti Teknologi MARA, Sg. Buloh Campus, Jalan Hospital, Sg. Buloh, Selangor, Malaysia.
Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA, Sg. Buloh Campus, Jalan Hospital, Sg. Buloh, Selangor, Malaysia.
Microbiol Spectr. 2025 Feb 4;13(2):e0087224. doi: 10.1128/spectrum.00872-24. Epub 2024 Dec 20.
Genetic characterization of multidrug-resistant (MDR) remains scarce in Malaysia. This study aimed to characterize antibiotic resistance, genomic location, and genetic relatedness among the isolates obtained from a tertiary hospital in Malaysia. A total of 128 MDR isolates were collected from patients admitted to various wards (intensive care unit [ICU], neonatal intensive care unit, coronary care unit, high dependency ward [HDW], and general wards). The isolates were identified by Vitek 2 and PCR amplification of the 16S rRNA gene followed by sequencing. The isolates were tested against imipenem, ceftazidime, amikacin, gentamicin, ampicillin, and ciprofloxacin using disk diffusion, Epsilometer test, and broth microdilution. The antibiotic resistance genes, , , , and , were detected in chromosomal and plasmid DNA using PCR. Insertion sequence IS1/ gene was detected on chromosomal DNA only. Isolates with different antibiotic susceptibility patterns and PCR profiles were subjected to multi-locus sequence typing. MDR was predominantly found in HDW (39.84%), general wards (29.69%), and ICU (28.13%). All isolates conferred resistance to carbapenem and more than 90% resistance to the remaining antibiotics. The antibiotic resistance genes , and were detected in both chromosomal and plasmid DNA. The IS1/ gene was detected in 99.22% of the isolates. Four sequence types (STs) were distinguished: ST2 (76.67%), ST164 (10%), ST642 (10%), and ST643 (3.33%). ST164 and ST642 were unique and represent a significant finding in Malaysia's surveillance data. These STs are associated with acquired , indicating an evolutionary adaptation of within the hospital setting.IMPORTANCE is a ubiquitous Gram-negative coccobacillus bacterium that is primarily associated with nosocomial infections that can colonize biotic and abiotic surfaces to enhance cell-to-cell adhesion, ensuring the establishment of infections. To date, the spread of multidrug-resistant (MDRAB) has become rampant and a great concern in the hospital setting, as the available antibiotics are insufficient to treat infections. The antibiotic resistance island resides in a mobile element and rapidly evolved. The antibiotic susceptibility data with its resistance mechanisms would contribute to and facilitate the management and infection control caused by MDRAB.
在马来西亚，耐多药（MDR）的基因特征研究仍然匮乏。本研究旨在对从马来西亚一家三级医院分离出的菌株进行抗生素耐药性、基因定位及基因相关性分析。共从入住不同病房（重症监护病房[ICU]、新生儿重症监护病房、冠心病监护病房、高依赖病房[HDW]和普通病房）的患者中收集了128株MDR菌株。通过Vitek 2和16S rRNA基因的PCR扩增及测序来鉴定菌株。使用纸片扩散法、E试验和肉汤微量稀释法对菌株进行亚胺培南、头孢他啶、阿米卡星、庆大霉素、氨苄西林和环丙沙星的药敏试验。采用PCR检测染色体和质粒DNA中的抗生素耐药基因blaOXA-23、blaOXA-51、blaADC、blaOmp33-36、blaTEM和blaSHV。插入序列IS1/Tn2基因仅在染色体DNA上检测到。对具有不同抗生素敏感性模式和PCR图谱的菌株进行多位点序列分型。MDR菌株主要在HDW（39.84%）、普通病房（29.69%）和ICU（28.13%）中发现。所有菌株均对碳青霉烯类耐药，对其余抗生素的耐药率超过90%。在染色体和质粒DNA中均检测到抗生素耐药基因blaOXA-23、blaOXA-51和blaADC。99.22%的菌株中检测到IS1/Tn2基因。区分出四种序列类型（STs）：ST2（76.67%）、ST164（10%）、ST642（10%）和ST643（3.33%）。ST164和ST642是独特的，代表了马来西亚监测数据中的一项重要发现。这些STs与获得性blaOXA-23相关，表明鲍曼不动杆菌在医院环境中的进化适应性。重要性鲍曼不动杆菌是一种普遍存在的革兰氏阴性球杆菌，主要与医院感染相关，它可以在生物和非生物表面定殖以增强细胞间粘附，从而确保感染的建立。迄今为止，耐多药鲍曼不动杆菌（MDRAB）的传播已变得猖獗，在医院环境中引起了极大关注，因为现有的抗生素不足以治疗感染。抗生素耐药岛存在于可移动元件中且迅速进化。其抗生素敏感性数据及其耐药机制将有助于并促进MDRAB引起的感染管理和控制。
