Cordeiro Nicolás F, Papa-Ezdra Romina, Traglia Germán, Bado Inés, García-Fulgueiras Virginia, Cortinas María N, Caiata Leticia, López-Vega Mariana, Otero Ana, López Martín, Hitateguy Patricia, Mogdasy Cristina, Vignoli Rafael
Unidad Académica de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Av. Alfredo Navarro 3051, Montevideo 11600, Uruguay.
Unidad de Genómica y Bioinformática, Departamento de Ciencias Biológicas, CENUR Litoral Norte, Universidad de la República, Salto 50000, Uruguay.
Antibiotics (Basel). 2025 Jun 18;14(6):620. doi: 10.3390/antibiotics14060620.
Infections caused by carbapenem-resistant Enterobacterales have steadily multiplied over time, becoming a major threat to healthcare systems due to limited therapeutic options and high case-fatality rates.
We studied a patient who, after being discharged from an ICU, developed salmonellosis caused by an antibiotic-susceptible . After undergoing treatment with ciprofloxacin, the patient presented an episode of asymptomatic bacteriuria originated by a carbapenem and ciprofloxacin-resistant .
Whole genome sequencing analysis revealed that both isolates belonged to the same strain, and that isolate SEn_T2 acquired a plasmid carrying both and genes (pIncCSEn) which was previously present in the patient's gut in at least one isolate. Additionally, pIncCSEN was identified as a putatively new sub-lineage of IncC2 plasmids which lacked the first copy of the methyltransferase gene and the gene. The resistance genes and were incorporated into a Tn-derived transposon that included a complex class 1 integron whose genetic arrangement was: - - - - --IS- - - (in reverse direction)- IS-IS- - - -.
Antimicrobial persistence and co-selection of antibiotic resistance play an important role in the dissemination of antimicrobial resistance genes; in this regard, a joint effort involving the infection control team, effective antibiotic stewardship, and genomic surveillance could help mitigate the spread of these multidrug resistant microorganisms.
随着时间的推移，耐碳青霉烯类肠杆菌科细菌引起的感染不断增加，由于治疗选择有限和高病死率，已成为医疗系统的重大威胁。
我们研究了一名从重症监护病房出院后发生由抗生素敏感菌引起的沙门氏菌病的患者。在用环丙沙星治疗后，该患者出现了一次由耐碳青霉烯类和环丙沙星的细菌引起的无症状菌尿症。
全基因组测序分析表明，这两种分离株属于同一菌株，并且分离株SEn_T2获得了一个携带blaCTX-M-15和blaNDM-1基因的质粒（pIncCSEn），该质粒先前至少在患者肠道中的一种大肠杆菌分离株中存在。此外，pIncCSEN被鉴定为IncC2质粒的一个假定新亚谱系，其缺少甲基转移酶基因armA的第一个拷贝和blaOXA-48基因。耐药基因blaCTX-M-15和blaNDM-1被整合到一个源自Tn的转座子中，该转座子包含一个复杂的1类整合子，其基因排列为：-aadA2-qacEΔ1-sul1-IS26--IS26（反向）-IS26-IS26--。
抗菌药物的持续存在和抗生素耐药性的共选择在抗菌药物耐药基因的传播中起重要作用；在这方面，感染控制团队、有效的抗生素管理和基因组监测的共同努力有助于减轻这些多重耐药微生物的传播。
