Wang Ying, Zhao Dan, Fan Yeshun, Cui Yanxiang, Wang Yingdi, Guan Xiaoxuan, Yu Linhong, Yuan Shunqian, Wang Lan, Hu Jianqiang, Li Yisong, Xia Wenbo, Liu Jie
School of Public Health, Qingdao University, Qingdao, Shandong, China.
Department of Clinical Laboratory, Qingdao Huangdao District Traditional Chinese Medicine Hospital, Qingdao, Shandong, China.
Front Cell Infect Microbiol. 2025 Jul 30;15:1601779. doi: 10.3389/fcimb.2025.1601779. eCollection 2025.
poses a profound global health threat because of multidrug resistance and its association with nosocomial infections. However, standard clinical diagnostics often report it together with other species as complex (ABC), which unavoidably conceals the attribution of non- species. This study reported orthopedic infection cases associated with different species and characterized the genomes of the culture isolates to evaluate their potential impact on the clinical treatment.
Nine in-patients with complex identified by culture during hospitalization were enrolled by the Orthopedics Department from a local hospital in Qingdao, China. Their clinical data were reviewed. One ABC isolate from each patient was tested for drug susceptibility and subjected for whole-genome sequencing, followed by bioinformatic analyses.
Through whole-genome analysis, nine ABC isolates were identified as six , two , and one with distinct antibiotic resistance profiles and phylogenetic characteristics, indicating progressing pathogen transmission across broad geographic regions in One Health perspective. All and strains carried multidrug resistance genes, while bore only and . Phenotypically, eight isolates were susceptible to almost all the antibiotics tested, with only one being multidrug resistant. Despite this, eight patients received cephalosporins following positive reports of complex.
Our study highlighted the limitation of current clinical diagnostic approaches for non- cases, which tended to be overtreated, and suggested that etiology landscape should be explored further beyond to avoid antibiotic misuse.
由于多重耐药性及其与医院感染的关联，它构成了严重的全球健康威胁。然而，标准临床诊断通常将其与其他菌种一起报告为复杂菌（ABC），这不可避免地掩盖了非该菌种的归因。本研究报告了与不同菌种相关的骨科感染病例，并对培养分离株的基因组进行了表征，以评估它们对临床治疗的潜在影响。
中国青岛一家当地医院的骨科收治了9名住院期间经培养鉴定为复杂菌的患者。回顾了他们的临床资料。对每位患者的一株ABC分离株进行药敏试验，并进行全基因组测序，随后进行生物信息学分析。
通过全基因组分析，9株ABC分离株被鉴定为6株[具体菌种1]、2株[具体菌种2]和1株[具体菌种3]，具有不同的抗生素耐药谱和系统发育特征，从“同一健康”视角表明病原体在广泛地理区域的传播在不断进展。所有[具体菌种1]和[具体菌种2]菌株都携带多重耐药基因，而[具体菌种3]仅携带[具体耐药基因1]和[具体耐药基因2]。表型上，8株分离株对几乎所有测试抗生素敏感，只有1株[具体菌种1]具有多重耐药性。尽管如此，8名患者在复杂菌报告呈阳性后接受了头孢菌素治疗。
我们的研究突出了当前非[目标菌种]病例临床诊断方法的局限性，这类病例往往接受了过度治疗，并建议应进一步探索除[目标菌种]之外的[目标菌种]病因情况，以避免抗生素滥用。
