Escherichia coli ST131 isolated from urological patients can acquire plasmid-mediated extended spectrum β-lactamase from other bacteria with high frequency
Escherichia coli ST131 isolated from urological patients can acquire plasmid-mediated extended spectrum β-lactamase from other bacteria with high frequency
复制标题
从泌尿科患者中分离出的大肠杆菌 ST131 可以高频率地从其他细菌中获得质粒介导的广谱 β-内酰胺酶
DOI：
10.1111/iju.14845
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Sakai H.
中科院分区：
文献类型：
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作者：
Kondo T;Sakamoto K;Morinaga Y;Miyata Y;Yanagihara K;Sakai H.
目的了解泌尿系患者大肠杆菌克隆群ST131的流行情况，探讨ST131耐药基因高发的机制。方法采用2018年1月至2018年12月在长崎大学附属医院泌尿外科采集的大肠杆菌65株。所有患者均进行多位点序列分型，并分析与喹诺酮类药物耐药和广谱β -内酰胺酶相关的基因。为了比较ST131和非ST131菌株，进行了细菌结合实验和肠道定植评估。结果st131在所有菌株中最占优势，左氧氟沙星耐药菌株占32%，β -内酰胺酶扩展谱阳性菌株占63%，β -内酰胺酶扩展谱阳性菌株占73%。15株产β -内酰胺酶的大肠杆菌中有12株含有CTX - M - 9。特别是，所有产生β -内酰胺酶的ST131菌株都具有CTX - M - 9。存在或不存在喹诺酮类药物耐药区突变的ST131菌株比例分别显著高于和低于非ST131菌株（P= 0.0002和P< 0.0001）。当肺炎克雷伯菌作为供体时，3株ST131菌株获得扩展谱β -内酰胺酶共16次（分别为6次、4次和6次），显著高于1株非ST131菌株（2次）。ST131菌株的细菌数量明显低于给予小鼠的非ST131菌株。ST131和非ST131菌株在给药万古霉素后再次增加，即使没有检测到菌落。结论这些结果支持了ST131菌株在医院，特别是泌尿科患者中流行的机制。
ObjectivesTo investigate the prevalence of the clonal groupEscherichia coliST131 in urologic patients, and to clarify the mechanisms underlying the high prevalence of the antimicrobial resistant genes in ST131.MethodsWe used 65Escherichia colistrains collected from the Department of Urology, Nagasaki University Hospital, between January 2018 and December 2018. All of them underwent multilocus sequence typing and were analyzed for genes associated with quinolone resistance and extended‐spectrum β‐lactamases. To compare ST131 and non‐ST131 strains, bacterial conjugation experiments and intestinal colonization evaluations were performed.ResultsST131 was the most dominant among all the strains, along with levofloxacin resistant strains, and extended‐spectrum β‐lactamases positive strains (32%, 63%, and 73%, respectively). 12 out of 15 extended‐spectrum β‐lactamases‐producingEscherichia colistrains harbored CTX‐M‐9. In particular, all extended‐spectrum β‐lactamases‐producing ST131 strains possessed CTX‐M‐9. The proportions of ST131 strains with or without quinolone resistance‐determining region mutations were significantly higher and lower, respectively, than that of non‐ST131 strains (P= 0.0002 andP< 0.0001, respectively). WhenKlebsiella pneumoniaewas used as a donor, three ST131 strains acquired extended‐spectrum β‐lactamases a total of 16 times (six, four, and six times each), which was significantly more than that in one of the non‐ST131 strains (two times). The amount of bacteria was significantly lower in the ST131 strains than in the non‐ST131 strains administered to mice. Both the ST131 and non‐ST131 strains increased again after the administration of vancomycin, even after the colony was not detected.ConclusionsThese results support the mechanisms underlying the prevalence of ST131 strains in hospitals, particularly in urologic patients.