Deng Shiyong, Li Changzhen, Zhang Hui, Xie Yuduan, Wang Xiaomei, Luo Wanjun, Chen Zhi, Tang Feng
Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People's Republic of China.
Laboratory Department, Qiaokou Center for Disease Control and Prevention, Wuhan, 430030, People's Republic of China.
Infect Drug Resist. 2025 Jul 28;18:3745-3760. doi: 10.2147/IDR.S522808. eCollection 2025.
This study aims to delineate the epidemiological characteristics and antibiotic resistance of isolates from Wuhan, focusing on serotype distribution, resistance patterns, and genetic diversity.
Our study analyzed 40 isolates collected from 2011 to 2022 in Wuhan, assessing their serotype distribution and resistance to multiple antibiotics. We conducted resistance gene detection and genetic diversity analysis using polymerase chain reaction and pulsed-field gel electrophoresis (PFGE), respectively.
The study revealed significant clustering of in the Jianghan and Dongxihu districts, with serotype 2a predominating. Isolates exhibited high resistance to ampicillin, tetracycline, and trimethoprim-sulfamethoxazole, with an overall multidrug resistance (MDR) rate of 67.5%. Serotypes 1b and 2b were fully sensitive, contrasting with higher resistance in serotypes 2a and 4a to fluoroquinolones. Resistance mechanisms included and for ampicillin, for cephalosporins, for tetracycline, and and for trimethoprim-sulfamethoxazole. All 12 quinolone-resistant isolates exhibited mutations in ( (), and (), and novel mutations were identified in (), (), and (). Pulsed-field gel electrophoresis (PFGE) analysis highlighted extensive genetic diversity with dominant groups P1 and P4, and with notable regional and temporal distribution patterns. Distinct PFGE types exhibited unique antimicrobial resistance profiles, with P1 and P4 showing high rates of multidrug resistance, while P5 and P3 displayed lower resistance levels. A notable evolutionary adaptation was observed in a clone from 2016 (P4-1), which by 2017 (P4-2) had acquired aminoglycoside resistance.
The study underscores the significant regional specificity and genetic diversity of in Wuhan, which poses challenges for treatment due to high antibiotic resistance and MDR prevalence. Findings stress the need for enhanced surveillance and tailored public health strategies to manage shigellosis effectively.
本研究旨在描绘武汉分离株的流行病学特征和抗生素耐药性，重点关注血清型分布、耐药模式和遗传多样性。
我们的研究分析了2011年至2022年在武汉收集的40株分离株，评估其血清型分布和对多种抗生素的耐药性。我们分别使用聚合酶链反应和脉冲场凝胶电泳（PFGE）进行耐药基因检测和遗传多样性分析。
研究显示，分离株在江汉区和东西湖区显著聚集，血清型2a占主导地位。分离株对氨苄西林、四环素和甲氧苄啶-磺胺甲恶唑表现出高耐药性，总体多重耐药（MDR）率为67.5%。血清型1b和2b完全敏感，而血清型2a和4a对氟喹诺酮类药物的耐药性较高。耐药机制包括氨苄西林的blaTEM和blaSHV、头孢菌素的blaCTX-M、四环素的tet(A)、甲氧苄啶-磺胺甲恶唑的sul1和sul2。所有12株耐喹诺酮类分离株均在gyrA（Ser83Leu、Ser83Phe）和parC（Ser80Ile）中出现突变，并且在gyrB（Asp426Asn）、marR（Ser116Phe）和acrR（Arg48Gln）中发现了新的突变。脉冲场凝胶电泳（PFGE）分析突出了广泛的遗传多样性，主要群体为P1和P4，并且具有明显的区域和时间分布模式。不同的PFGE类型表现出独特的抗菌耐药谱，P1和P4显示出高多重耐药率，而P5和P3显示出较低的耐药水平。在一株2016年的克隆株（P4-1）中观察到显著的进化适应性，到2017年（P4-2）它获得了氨基糖苷类耐药性。
该研究强调了武汉分离株的显著区域特异性和遗传多样性，由于高抗生素耐药性和MDR流行率，这给治疗带来了挑战。研究结果强调需要加强监测并制定针对性的公共卫生策略，以有效管理志贺菌病。
