2022年和2023年从乌克兰战斗伤口分离出的[具体物质未提及]的表型和基因型分析。
Phenotypic and genotypic analysis of isolated from combat wounds in Ukraine during 2022 and 2023.
作者信息
Kondratiuk V M, Jones Brendan T, Luo Ting L, Fomina N S, Lebreton Francois, Bennett Jason W, Mc Gann Patrick, Kovalchuk V P
机构信息
Department of Emergency and Military Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Multidrug-Resistant Organism Repository and Surveillance Network (MRSN), Bacterial Diseases Branch, CIDR, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
出版信息
JAC Antimicrob Resist. 2025 Aug 7;7(4):dlaf140. doi: 10.1093/jacamr/dlaf140. eCollection 2025 Aug.
BACKGROUND
is an important nosocomial pathogen worldwide. During the current invasion of Ukraine, reports of infections caused by this organism have proliferated. Here, we provide a phenotypic and genotypic analysis of associated with the conflict.
METHODS
Between March 2022 and September 2023, 68 strains were cultured from wounded Ukrainian service members in three hospitals in west-central Ukraine. Antibiotic susceptibility and WGS were performed on all isolates.
RESULTS
Strains encompassed eight different STs, including the emerging ST78 (and its single locus variant ST1077) and globally distributed ST2 lineages, with ST19 being the most common (25%). Fifty strains carried at least one acquired carbapenemase ( or ), with seven strains carrying both. Overall, susceptibility ranged from 0% (fluoroquinolones) to 100% (SUL/durlobactam) and all strains had CST MICs <1 mg/mL. Notably, all but one ST2 isolates were resistant to FDC, and this correlated with the presence of the or ESBL genes. In contrast, 8 of 13 ST78 were FDC non-susceptible, but non-susceptibility was correlated with the disruption of the siderophore receptor gene by IS. Finally, passage in MEM of one strain for 8 days resulted in a mutation of the ESBL to the carbapenemase.
CONCLUSIONS
Sampling of strains infecting injured Ukrainian soldiers revealed the predominance of known (ST2) and emerging (ST19, ST78) lineages carrying carbapenemases. Antibiotic resistance was broad, including the recently approved catechol-substituted siderophore cephalosporin, FDC, highlighting the immense treatment challenges faced by medical personnel during this ongoing conflict.
背景
是全球范围内一种重要的医院病原体。在当前乌克兰冲突期间，由这种病原体引起的感染报告激增。在此，我们提供了与该冲突相关的 的表型和基因型分析。
方法
2022年3月至2023年9月期间，从乌克兰中西部三家医院的受伤乌克兰军人中培养出68株 菌株。对所有分离株进行了药敏试验和全基因组测序（WGS）。
结果
菌株包括8种不同的序列类型（STs），包括新兴的ST78（及其单一位点变体ST1077）和全球分布的ST2谱系，其中ST19最为常见（25%）。50株携带至少一种获得性碳青霉烯酶（ 或 ），7株同时携带两种。总体而言，药敏率从0%（氟喹诺酮类）到100%（SUL/度洛巴坦），所有菌株的头孢他啶-阿维巴坦（CST）最低抑菌浓度（MICs）<1 mg/mL。值得注意的是，除一株ST2分离株外，所有分离株均对复方制剂（FDC）耐药，这与 或 超广谱β-内酰胺酶（ESBL）基因的存在相关。相比之下，13株ST78中有8株对FDC不敏感，但不敏感与铁载体受体基因被插入序列（IS）破坏有关。最后，一株菌株在最低限度基本培养基（MEM）中传代8天导致 ESBL突变为 碳青霉烯酶。
结论
对感染受伤乌克兰士兵的 菌株进行采样发现，携带碳青霉烯酶的已知（ST2）和新兴（ST19、ST78）谱系占主导地位。抗生素耐药性广泛，包括最近批准的儿茶酚取代铁载体头孢菌素FDC，凸显了在这场持续冲突中医务人员面临的巨大治疗挑战。
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