Phenotypic and molecular characterization of beta-lactam resistant Multidrug-resistant Enterobacterales isolated from patients attending six hospitals in Northern Nigeria.
Phenotypic and molecular characterization of beta-lactam resistant Multidrug-resistant Enterobacterales isolated from patients attending six hospitals in Northern Nigeria.
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DOI：
10.1038/s41598-023-37621-z
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发表时间：
2023-06-26
影响因子：
4.6
通讯作者：
Obaro, Stephen K.
中科院分区：
文献类型：
--
作者：
Medugu, Nubwa;Tickler, Isabella A.;Duru, Carissa;Egah, Ruth;James, Abu Ocheiku;Odili, Vivian;Hanga, Fatima;Olateju, Eyinade Kudirat;Jibir, Binta;Ebruke, Bernard E.;Olanipekun, Grace;Tenover, Fred C.;Obaro, Stephen K.
耐多药肠杆菌（MDR-E）引起的感染难以治疗，并造成严重的死亡率，特别是在发展中国家。本研究利用全基因组测序技术，对49例随机选择的β -内酰胺耐药耐多药e进行了表型和基因型分析。这些耐药e以前是从尼日利亚医院接受治疗的患者中分离出来的。研究分离株对第3代头孢菌素的耐药率为85.5%，对碳青霉烯类的耐药率为65.3%。blaTEM-1B（29, 59.2%）、blaCTX-M-15（38, 77.6%）和blaNDM-1（17, 51.5%）分别是菌株中最常见的青霉素酶耐药基因、ESBL耐药基因和碳青霉烯类耐药基因。17个（45%）blaCTX-M-15基因与ISEc9插入序列相关，11个（64.7%）blaNDM-1基因与ISEc33插入序列相关。21个检测到的质粒中没有一个与β-内酰胺酶基因相关。大肠杆菌ST-88 （n = 2）和ST-692 （n = 2）耐药率较高。高危克隆ST-476 （n = 8）和ST-147 （n = 3）占优势，具有较高的表型耐药率和较多的AMR基因。抗生素耐药性的机制和模式不同于先前描述的具有广泛AMRGs的分离株的模式。在我们的研究中，几种染色体介导的碳青霉烯酶的检测也代表了一个重要的发现，值得进一步调查，以更好地了解其对临床实践和公共卫生的影响。所选的耐多药菌株对替加环素普遍敏感，对磷霉素的耐药性很低，这表明这些耐多药菌株有可能作为经治性治疗。结合传统实验室技术和现代分子技术的监测方法对于全面描述尼日利亚境内肠杆菌感染中抗菌素耐药性的出现和传播至关重要。
Infections caused by multi-drug resistant Enterobacterales (MDR-E) are difficult to treat and cause significant mortality, especially in developing countries. This study characterized the phenotypic and genotypic profiles of 49 randomly selected beta-lactam resistant MDR-E previously isolated from patients being managed in hospitals in Nigeria using whole genome sequencing. The study isolates exhibited 85.5% resistance to 3rd generation cephalosporins and 65.3% resistance to carbapenems. The blaTEM-1B (29, 59.2%), blaCTX-M-15 (38, 77.6%), and blaNDM-1 (17, 51.5%) were the most common penicillinase, ESBL, and carbapenem resistant genes across isolates, respectively. Seventeen (45%) of blaCTX-M-15 was carried on the insertion sequence ISEc9 while blaNDM-1 (11, 64.7%) were associated with ISEc33. None of the 21 plasmids detected were associated with β-lactamase genes. Higher resistance rates were found in E. coli ST-88 (n = 2) and the high-risk ST-692 (n = 2). For Klebsiella species, the high-risk clones ST-476 (n = 8) and ST-147 (n = 3) predominated and had higher phenotypic resistance rates and higher number of AMR genes. The mechanisms and pattern of antibiotic resistance differ from patterns previously described with isolates harbouring a wide range of AMRGs. The detection of several chromosomally mediated carbapenemases in our study also represents a significant finding that warrants further investigation to better understand its’ implications for clinical practice and public health. The selected MDR-Es were found to be pan-susceptible to tigecycline and had very low resistance to fosfomycin, suggesting a potential for these as empiric treatments. A surveillance approach incorporating both conventional laboratory techniques and modern molecular techniques is essential for the comprehensive characterization of the emergence and dissemination of antimicrobial resistance in Enterobacterales infections within Nigeria.
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影响因子：
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Duru C;Olanipekun G;Odili V;Kocmich N;Rezac A;Ajose TO;Medugu N;Umoru D;Onuchukwu C;Munir H;Jibir BW;Farouk Z;Gambo S;Hassan-Hanga F;Olaosebikan R;Ebruke B;Esimone C;Obaro S
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