Dong Su, Lou Jianjiang, Mao Caiping, Fang Yuejuan, Zhang Huan
Department of Clinical Laboratory, Shaoxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhejiang, China.
Department of Clinical Laboratory, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Zhejiang, China.
Front Microbiol. 2025 Aug 6;16:1575257. doi: 10.3389/fmicb.2025.1575257. eCollection 2025.
Nosocomial outbreaks caused by carbapenem-resistant (CRAB) strains are rapidly emerging worldwide and are a cause for concern. In this study, a phylogenetic tree of 18 strains collected from a teaching hospital in China was constructed to explore the genetic relationship in the context of genomic insights. The study also aimed to explore the relationship among the strains and to assess the potential spread within the teaching hospital. All CRAB strains were collected from 17 patients, with the majority obtained from sputum samples (55.56%, 10/18). Moreover, 61.11% (11/18) of the CRAB strains were collected from the intensive care unit (ICU). Whole-genome sequencing (WGS) was performed using the Illumina and Oxford Nanopore platforms, and the bioinformatic analysis was subsequently performed. Based on the Pasteur multilocus sequence typing (MLST) scheme, 16 strains were classified as sequence type 2 (ST2). The remaining two strains belonged to two rare sequence types (STs), namely ST34 and ST23, respectively. KL and OCL analysis showed that the majority of the strains (61.11%, 11/18) contained KL7. Whole-genome sequencing revealed that 16 CRAB strains were OXA-23 producers, while the remaining two strains carried and . Genetic structure analysis showed the context of was IS-IS - Comparative genomics analysis revealed that 16 CRAB strains (ST2_Pas) had a close genetic relationship, and 8 CRAB strains possessed the same resistance gene profile, with only 1-6 SNPs observed among them. Therefore, there is an urgent need for increased surveillance of both patients and the hospital environment to prevent and control the spread of CRAB.
由耐碳青霉烯类（CRAB）菌株引起的医院感染在全球范围内迅速出现，令人担忧。在本研究中，构建了从中国一家教学医院收集的18株菌株的系统发育树，以在基因组学见解的背景下探索遗传关系。该研究还旨在探索菌株之间的关系，并评估在教学医院内的潜在传播情况。所有CRAB菌株均从17名患者中收集，大多数菌株来自痰液样本（55.56%，10/18）。此外，61.11%（11/18）的CRAB菌株是从重症监护病房（ICU）收集的。使用Illumina和牛津纳米孔平台进行全基因组测序（WGS），随后进行生物信息学分析。根据巴斯德多位点序列分型（MLST）方案，16株菌株被分类为序列类型2（ST2）。其余两株菌株分别属于两种罕见的序列类型（STs），即ST34和ST23。KL和OCL分析表明，大多数菌株（61.11%，11/18）含有KL7。全基因组测序显示，16株CRAB菌株是OXA - 23产生菌，而其余两株菌株携带 和 。遗传结构分析显示 的背景是IS - IS - 比较基因组学分析表明，16株CRAB菌株（ST2_Pas）具有密切的遗传关系，8株CRAB菌株具有相同的耐药基因谱，其中仅观察到1 - 6个单核苷酸多态性（SNP）。因此，迫切需要加强对患者和医院环境的监测，以预防和控制CRAB的传播。
