Tóth Zoltán, Balázs Bence, Pfliegler Walter P, Csoma Eszter, Majoros László, Szűcs Dorka, Kovács Renátó
Medical Microbiology, Clinical Center, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Department of Molecular Biotechnology and Microbiology, Faculty of Science and Technology, University of Debrecen, 4032 Debrecen, Hungary.
Diagnostics (Basel). 2024 Dec 29;15(1):58. doi: 10.3390/diagnostics15010058.
: Monomicrobial necrotizing fasciitis is associated with exceedingly high mortality rates. Although effective antimicrobial therapy is an important part of treatment, the traditional microbiological diagnostic methods are not fast enough to meaningfully influence early therapeutic decisions. : Here, we report the application of the BioMérieux Biofire Filmarray Joint Infection Panel (BFJIP) for the rapid detection of the causative agent and susceptibility prediction in such a case. Aside from the BFJIP-based rapid diagnostic approach and culturing, the whole genome sequencing (WGS) of the causative agent was performed using Illumina MiSeq and Oxford Nanopore MinION platforms. : The BFJIP indicated the presence of , without KPC, VIM, IMP, NDM, OXA-48 carbapenemase genes, and CTX-M-type extended-spectrum beta-lactamases. Based on the WGS data, the isolate belonged to the K1-capsule-type ST23, harboured a pNTUH-2044-like plasmid, and was positive for all the virulence factors associated with this lineage. The conventional susceptibility results were also in accordance with the BFJIP results; the isolate lacked any of these acquired resistance mechanisms. : Despite this being the first case of the successful identification of pathogenic bacteria in necrotising fasciitis using this assay, the BFJIP may become a useful tool for rapid identification of pathogens in necrotising fasciitis cases and guiding antimicrobial therapy for better clinical outcomes.
单微生物坏死性筋膜炎的死亡率极高。尽管有效的抗菌治疗是治疗的重要组成部分,但传统的微生物诊断方法不够快速,无法对早期治疗决策产生有意义的影响。在此,我们报告了生物梅里埃Biofire Filmarray联合感染检测板(BFJIP)在此类病例中用于快速检测病原体和预测药敏性的应用。除了基于BFJIP的快速诊断方法和培养外,还使用Illumina MiSeq和牛津纳米孔MinION平台对病原体进行了全基因组测序。BFJIP显示存在[具体细菌名称未给出],无KPC、VIM、IMP、NDM、OXA - 48碳青霉烯酶基因以及CTX - M型超广谱β - 内酰胺酶。基于全基因组测序数据,分离株属于K1荚膜型ST23,携带一种类似pNTUH - 2044的质粒,并且与该菌系相关的所有毒力因子均呈阳性。传统药敏结果也与BFJIP结果一致;该分离株缺乏任何这些获得性耐药机制。尽管这是首例使用该检测方法成功鉴定坏死性筋膜炎致病细菌的病例,但BFJIP可能成为快速鉴定坏死性筋膜炎病例病原体并指导抗菌治疗以获得更好临床结果的有用工具。