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墨西哥一家三级护理医院中泛耐药性ST392KL27的克隆传播

Clonal Dissemination of Pandrug-Resistant ST392KL27 in a Tertiary Care Hospital in Mexico.

作者信息

Cortés-Ortíz Iliana Alejandra, Cortés-Malagón Enoc Mariano, García-Moncada Eduardo, Acosta-Altamirano Gustavo, Pineda-Migranas Jesús Alejandro, García-Prudencio Karen Lizzet, Mendieta-Condado Edgar, Araiza-Rodríguez Adnan, Bonilla-Cortés Alejandra Yareth, Sierra-Martínez Mónica, Bravata-Alcántara Juan Carlos

机构信息

Genetics and Molecular Diagnostics Laboratory, Hospital Juárez de México, Mexico City 0776, Mexico.

Research Division, Hospital Juárez de México, Mexico City 07760, Mexico.

出版信息

Int J Mol Sci. 2025 Aug 20;26(16):8047. doi: 10.3390/ijms26168047.

Abstract

The global emergence of multidrug- and pandrug-resistant poses a critical threat to public health, particularly in hospital settings. This study describes a nosocomial outbreak caused by in a tertiary-care hospital in Mexico and provides a comprehensive genomic analysis of six clinical isolates. All isolates exhibited pandrug resistance, including carbapenems and colistin. Whole-genome sequencing identified 37 antimicrobial resistance genes, including NDM-1, OXA-1, CTX-M-15, and a B R256G mutation associated with colistin resistance. Two conjugative plasmids (pAA046 and pAA276) carried multiple resistance genes and mobile genetic elements. Although all isolates harbored CRISPR-Cas type I-E systems, no spacers matched resistance plasmids, suggesting functional inactivity. Capsular typing identified the KL27 locus with the 187 allele. Phylogenetic and cgMLST analyses confirmed clonal dissemination and close genetic relatedness to strains from Europe and the USA. Despite the absence of classical hypervirulence markers, the presence of , , and genes indicates adaptation to the hospital environment. These findings confirm the clonal spread of pandrug-resistant ST392-KL27 in a Mexican hospital, underscoring the role of plasmid-mediated resistance and the potential for global dissemination.

摘要

多重耐药和泛耐药菌在全球的出现对公众健康构成了严重威胁,尤其是在医院环境中。本研究描述了墨西哥一家三级护理医院中由[细菌名称未给出]引起的医院感染暴发,并对六个临床分离株进行了全面的基因组分析。所有分离株均表现出泛耐药性,包括对碳青霉烯类和黏菌素的耐药。全基因组测序鉴定出37个抗菌药物耐药基因,包括NDM-1、OXA-1、CTX-M-15以及与黏菌素耐药相关的B R256G突变。两个接合质粒(pAA046和pAA276)携带多个耐药基因和可移动遗传元件。尽管所有分离株都含有I-E型CRISPR-Cas系统,但没有间隔序列与耐药质粒匹配,表明其功能不活跃。荚膜分型鉴定出具有187等位基因的KL27位点。系统发育和cgMLST分析证实了克隆传播以及与来自欧洲和美国的菌株的密切遗传相关性。尽管没有经典的高毒力标记,但[相关基因未给出]基因的存在表明其对医院环境的适应性。这些发现证实了泛耐药[细菌名称未给出]ST392-KL27在墨西哥一家医院中的克隆传播,强调了质粒介导的耐药性的作用以及全球传播的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f8c/12386949/58e26d71cc6f/ijms-26-08047-g001.jpg

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