通过[具体方式]在72小时临床演变过程中快速质粒介导获得红霉素耐药性
Rapid Plasmid-Mediated Acquisition of Erythromycin Resistance via in : A 72-Hour Clinical Evolution.
作者信息
Chen Zongyao, Jiang Yayun, Wang Dengchao, Jiang Shuming
机构信息
Department of Clinical Laboratory, People's Hospital of Deyang City, Deyang, People's Republic of China.
Pathogenic Microbiology and Clinical Immunology Key Laboratory of Deyang City, Deyang, People's Republic of China.
出版信息
Infect Drug Resist. 2025 Jul 29;18:3771-3777. doi: 10.2147/IDR.S531265. eCollection 2025.
PURPOSE
To investigate the genomic mechanisms driving rapid erythromycin resistance emergence in during clinical management of urinary tract infections.
METHODS
Longitudinal analysis of four isolates (C1-C4) from an ICU patient with candida coinfection was conducted using CLSI M45-A3-guided microbroth dilution and comparative whole-genome sequencing. Phylogenetic reconstruction (27 housekeeping genes) confirmed clonal origin, while CARD/PIPdb/ISfinder databases characterized resistome dynamics.
RESULTS
Erythromycin susceptibility shifted from susceptible (minimum inhibitory concentration, MIC ≤ 0.25 μg/mL) to resistant (MIC = 4 μg/mL) within 72 hours, correlating with acquisition of a plasmid carrying flanked by ISL3-family elements (ISCx1).
CONCLUSION
This first documentation of sub-72-hour plasmid acquisition in highlights critical infection control challenges in ICU settings. We recommend daily antimicrobial susceptibility testing (AST) profiling for in ICU patients receiving macrolides, coupled with PCR screening for to preempt resistance dissemination.
目的
研究在尿路感染临床管理期间驱动快速出现红霉素耐药性的基因组机制。
方法
使用CLSI M45 - A3指导的微量肉汤稀释法和比较全基因组测序，对一名合并念珠菌感染的ICU患者的四株分离株（C1 - C4）进行纵向分析。系统发育重建（27个管家基因）证实了克隆起源，而CARD/PIPdb/ISfinder数据库对耐药组动态进行了表征。
结果
红霉素敏感性在72小时内从敏感（最低抑菌浓度，MIC≤0.25μg/mL）转变为耐药（MIC = 4μg/mL），这与获得一个携带由ISL3家族元件（ISCx1）侧翼环绕的 erm 基因的质粒相关。
结论
这首次记录的在72小时内获得 erm 质粒的情况突出了ICU环境中关键的感染控制挑战。我们建议对接受大环内酯类药物治疗的ICU患者进行每日抗菌药物敏感性测试（AST）分析，并结合对 erm 基因的PCR筛查，以预防耐药性传播。
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