Zhang Ying, Zhou Beibei, Kong Jingchun, Hu Panjie, Liu Haifeng, Zhao Deyi, Ye Jianzhong, Fu Qingxia, Zhou Tieli, Qian Changrui
Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Antimicrob Agents Chemother. 2025 Jun 4;69(6):e0184324. doi: 10.1128/aac.01843-24. Epub 2025 Apr 23.
-truncated (ATAB) isolates are associated with elevated tigecycline resistance and enhanced virulence, yet its epidemic dynamics and genomic features remain poorly understood. This study aimed to investigate the epidemiology of ATAB isolates, identify infection risk factors, and assess their impact on patient prognosis. The prevalence of ATAB isolates in a tertiary care teaching hospital (Wenzhou, China) from January 2018 to December 2022 was determined via polymerase chain reaction (PCR) screening. Whole-genome sequencing and genomic analysis were conducted to explore the epidemiology and genomic characteristics of 254 ATAB isolates. Clinical data analysis was performed to identify risk factors for ATAB infection and its correlation with patient prognosis. The results of local sample analysis showed that truncation was identified in 26.5% (486/1834) of the patient isolates, with the monthly prevalence peaking at 64.9% (24/37). The capsular types of ATAB isolates were primarily KL2, whereas -complete isolates exhibited a greater capsular diversity. ATAB could evolve within the hospital and lead to multiple nosocomial clonal transmissions. Most ATAB isolates exhibited co-resistance to carbapenems and tigecycline. ICU admission and use of immunosuppressants were significant risk factors for ATAB isolate infection. Patients infected with ATAB isolates had significantly higher 28-day all-cause mortality (32.8%, 20/61) compared to those infected with -complete isolates (11.5%, 7/61, < 0.01). Bioinformatics analysis of the 18,946 completed and draft genome assemblies from the GenBank database showed that ATAB isolates were widely prevalent worldwide. This study highlights the importance of early identification and monitoring of ATAB isolates as a critical marker for hospital infection control.
截短型（ATAB）菌株与替加环素耐药性升高和毒力增强有关，但其流行动态和基因组特征仍知之甚少。本研究旨在调查 ATAB 菌株的流行病学，确定感染风险因素，并评估其对患者预后的影响。通过聚合酶链反应（PCR）筛查确定了 2018 年 1 月至 2022 年 12 月期间一家三级护理教学医院（中国温州）中 ATAB 菌株的流行情况。对 254 株 ATAB 菌株进行了全基因组测序和基因组分析，以探索其流行病学和基因组特征。进行临床数据分析以确定 ATAB 感染的风险因素及其与患者预后的相关性。局部样本分析结果显示，在 26.5%（486/1834）的患者分离株中鉴定出截短型，月患病率峰值为 64.9%（24/37）。ATAB 菌株的荚膜类型主要为 KL2，而完整菌株表现出更大的荚膜多样性。ATAB 可在医院内进化并导致多次医院内克隆传播。大多数 ATAB 菌株对碳青霉烯类和替加环素表现出共同耐药性。入住重症监护病房和使用免疫抑制剂是 ATAB 菌株感染的重要风险因素。与感染完整菌株的患者（11.5%，7/61，P<0.01）相比，感染 ATAB 菌株的患者 28 天全因死亡率显著更高（32.8% , 20/61）。对来自 GenBank 数据库的 18946 个完整和草图基因组组装进行的生物信息学分析表明，ATAB 菌株在全球广泛流行。本研究强调了早期识别和监测 ATAB 菌株作为医院感染控制关键标志物的重要性。
