Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries.
Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries.
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DOI：
10.1038/s41564-021-00870-7
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发表时间：
2021-04
影响因子：
28.3
通讯作者：
Walsh TR
中科院分区：
文献类型：
--
作者：
Sands K;Carvalho MJ;Portal E;Thomson K;Dyer C;Akpulu C;Andrews R;Ferreira A;Gillespie D;Hender T;Hood K;Mathias J;Milton R;Nieto M;Taiyari K;Chan GJ;Bekele D;Solomon S;Basu S;Chattopadhyay P;Mukherjee S;Iregbu K;Modibbo F;Uwaezuoke S;Zahra R;Shirazi H;Muhammad A;Mazarati JB;Rucogoza A;Gaju L;Mehtar S;Bulabula ANH;Whitelaw A;BARNARDS Group;Walsh TR
新生儿败血症中的抗生素耐药性正在上升，但耐药机制通常通过移动遗传元件在物种之间传播，最终限制了低收入和中等收入国家 (LMIC) 的治疗，但对其机制的描述却很少。发展中社会新生儿抗生素耐药性负担 (BARNARDS) 网络的启动是为了描述非洲和南亚七个中低收入国家新生儿败血症抗生素耐药性的原因和负担。 2015年11月至2017年12月期间，共有36,285名新生儿参加了BARNARDS研究，其中2,483人被诊断患有培养确诊的脓毒症。肺炎克雷伯菌 (n = 258) 是新生儿败血症的主要原因，粘质沙雷氏菌 (n = 151)、密歇根克雷伯菌 (n = 117)、大肠杆菌 (n = 75) 和阴沟肠杆菌复合体 (n = 57) 也是引起新生儿败血症的主要原因。检测到。我们提供了 1,038 例新生儿败血症分离株中 916 例的全基因组测序、抗菌药物敏感性和临床数据（其中 97 例分离株未从当地最初隔离中回收）。肠杆菌目（肺炎克雷伯菌、大肠杆菌和阴沟肠杆菌）携带多种头孢菌素和碳青霉烯类耐药基因。所有分离的病原体都对多种抗生素具有耐药性，包括用于治疗新生儿败血症的抗生素。肺炎克雷伯菌和大肠杆菌的种内多样性表明多种抗生素耐药谱系导致新生儿败血症。我们的研究结果将支持中低收入国家更好地治疗新生儿败血症的研究。对七个低收入和中等收入国家败血症新生儿的 916 株细菌分离株进行的基因组和临床分析（BARNARDS 研究）表明，存在的主要菌种是耐药克雷伯氏菌、大肠杆菌和肠杆菌。
Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of resistance that often spread between species via mobile genetic elements, ultimately limiting treatments in low- and middle-income countries (LMICs), are poorly characterized. The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) network was initiated to characterize the cause and burden of antimicrobial resistance in neonatal sepsis for seven LMICs in Africa and South Asia. A total of 36,285 neonates were enrolled in the BARNARDS study between November 2015 and December 2017, of whom 2,483 were diagnosed with culture-confirmed sepsis. Klebsiella pneumoniae (n = 258) was the main cause of neonatal sepsis, with Serratia marcescens (n = 151), Klebsiella michiganensis (n = 117), Escherichia coli (n = 75) and Enterobacter cloacae complex (n = 57) also detected. We present whole-genome sequencing, antimicrobial susceptibility and clinical data for 916 out of 1,038 neonatal sepsis isolates (97 isolates were not recovered from initial isolation at local sites). Enterobacterales (K. pneumoniae, E. coli and E. cloacae) harboured multiple cephalosporin and carbapenem resistance genes. All isolated pathogens were resistant to multiple antibiotic classes, including those used to treat neonatal sepsis. Intraspecies diversity of K. pneumoniae and E. coli indicated that multiple antibiotic-resistant lineages cause neonatal sepsis. Our results will underpin research towards better treatments for neonatal sepsis in LMICs. Genomic and clinical analysis of 916 bacterial isolates from neonates with sepsis in seven low- and middle-income countries (the BARNARDS study) reveals that the main species present were antimicrobial-resistant Klebsiella, Escherichia coli and Enterobacter.
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影响因子：
3.9
作者：
Connor TR;Loman NJ;Thompson S;Smith A;Southgate J;Poplawski R;Bull MJ;Richardson E;Ismail M;Thompson SE;Kitchen C;Guest M;Bakke M;Sheppard SK;Pallen MJ
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Tarr, Phillip I.