Lebreton Francois, Kondratiuk Viacheslav, Kovalchuk Valentyn, Pfennigwerth Niels, Luo Ting L, Jones Brendan T, Fomina Nadiia, Fuchs Frieder, Hans Jörg B, Eisfeld Jessica, Ong Ana, Gatermann Sören, Bennett Jason W, Mc Gann Patrick
Multidrug-Resistant Organism Repository and Surveillance Network (MRSN), Diagnostics and Countermeasures Branch, CIDR, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Room 2A36, Silver Spring, MD, 20910, USA.
Department of Emergency and Military Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Genome Med. 2025 Jul 1;17(1):74. doi: 10.1186/s13073-025-01500-1.
The Russian invasion of Ukraine in 2022 has placed extraordinary pressure on hospitals there. One consequence of this has been the alarming increase in infections caused by multi-drug resistant organisms (MDROs), both within Ukraine and among the Ukrainian diaspora. The original source of these MDROs remains obscure although nosocomial origin is suspected. Here, we analyzed a collection of Acinetobacter baumannii and Pseudomonas aeruginosa collected from Ukraine before and after the invasion to glean a greater understanding of their relationship and origins.
Genomic analysis was conducted on 167 A. baumannii and 93 P. aeruginosa cultured from 223 Ukrainian patients hospitalized in Ukraine or other European countries. Fifty-three isolates were cultured between 2014 and 2021, prior to the invasion, and the remaining 207 after.
Highly genetically related extensively-drug resistant (XDR) clones were identified that spanned the pre- and post-invasion periods. For A. baumannii, isolates encompassed three sequence types (STs), including carbapenemase-producing strains from ST-2 (bla) and ST-78 (bla), as well as ST-400 carrying the ESBL bla. For P. aeruginosa, isolates encompassed three STs: ST-773 carrying bla, ST-1047 carrying bla, and ST-244. For all, the mobile genetic elements associated with carbapenemase carriage were fully characterized. Notably, post-invasion ST-773 and ST-1047 P. aeruginosa had a signature of host adaptation with multiple loss-of-function mutations in the quorum-sensing regulator LasR, known to modulate immune responses and provide survival advantages in animal models of infection.
XDR epidemic clones circulating in Ukraine and across Europe since 2022 share a close genetic relationship to historical strains from Ukraine. In some cases, direct links to medical facilities within Ukraine can be inferred. These data suggest that surveillance efforts should focus on tracking nosocomial transmission within Ukrainian hospitals while infection control efforts are being disrupted by the ongoing Russian invasion.
2022年俄罗斯对乌克兰的入侵给当地医院带来了巨大压力。这一情况导致了耐多药微生物（MDROs）引起的感染在乌克兰境内以及乌克兰侨民中惊人地增加。尽管怀疑这些MDROs的源头是医院，但它们的最初来源仍不明朗。在此，我们分析了一批在入侵前后从乌克兰收集的鲍曼不动杆菌和铜绿假单胞菌，以更深入地了解它们之间的关系和起源。
对从在乌克兰或其他欧洲国家住院的223名乌克兰患者身上培养出的167株鲍曼不动杆菌和93株铜绿假单胞菌进行了基因组分析。其中53株分离株是在2014年至2021年入侵之前培养的，其余207株是在入侵之后培养的。
鉴定出了在入侵前后时期都存在的高度遗传相关的广泛耐药（XDR）克隆。对于鲍曼不动杆菌，分离株包括三种序列类型（STs），包括来自ST-2（bla）和ST-78（bla）的产碳青霉烯酶菌株，以及携带ESBL bla的ST-400。对于铜绿假单胞菌，分离株包括三种STs：携带bla的ST-773、携带bla的ST-1047和ST-244。对于所有这些菌株，与碳青霉烯酶携带相关的移动遗传元件都得到了充分表征。值得注意的是，入侵后的ST-773和ST-1047铜绿假单胞菌具有宿主适应性特征，在群体感应调节因子LasR中存在多个功能丧失突变，已知该调节因子可调节免疫反应并在感染动物模型中提供生存优势。
自2022年以来在乌克兰和欧洲传播的XDR流行克隆与乌克兰的历史菌株具有密切的遗传关系。在某些情况下，可以推断出与乌克兰境内医疗机构的直接联系。这些数据表明，在俄罗斯持续入侵导致感染控制工作受到干扰的情况下，监测工作应侧重于追踪乌克兰医院内的医院感染传播情况。
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