Ceftriaxone-resistant Salmonella Typhi carries an IncI1-ST31 plasmid encoding CTX-M-15.
Ceftriaxone-resistant Salmonella Typhi carries an IncI1-ST31 plasmid encoding CTX-M-15.
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头孢曲松耐药伤寒沙门氏菌携带编码 CTX-M-15 的 IncI1-ST31 质粒。
DOI：
10.1099/jmm.0.000727
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发表时间：
2018
影响因子：
3
通讯作者：
Djeghout B
中科院分区：
文献类型：
--
作者：
Djeghout B
目的：头孢曲松是治疗伤寒的首选药物，而耐药伤寒沙门氏菌的出现引起了治疗的主要关注。头孢曲松耐药的零星报告不断增加。必须优先考虑伤寒和限制患者治疗失败以及社区暴发的风险。本研究描述了使用全基因组测序来指导疫情识别和病例管理。方法论。头孢曲松耐药菌株的分离。使用 Illumina NextSeq 500 对 2000 年在孟加拉国达卡大众诊断中心采集的一名儿童血液中的伤寒杆菌进行全基因组测序，并使用 Geneious 软件进行分析。结果/主要发现。与其他头孢曲松耐药药物进行比较。 2015 年，来自刚果民主共和国的伤寒分离株被发现是伤寒伤寒的近亲，但没有证据表明伤寒暴发。鉴定出属于不相容性组I1 (IncI1-ST31)的质粒，其包括与ISEcp-1相关的blaCTX-M-15(头孢曲松抗性)。与来自 S 的 IncI1 质粒 pS115 具有高度相似性 (90 %)。肠炎球菌，以及 pESBL-EA11，一种来自大肠杆菌的 incI1 质粒。大肠杆菌(99 %)表明伤寒沙门氏菌通过获得通用质粒获得了头孢曲松耐药性。结论。头孢曲松耐药性从大肠杆菌中的传播。伤寒杆菌由于临床上对头孢曲松（伤寒治疗的主要药物）耐药而受到关注。尽管在隔离几年后进行的全基因组测序证明了遏制措施的成功，但迫切需要使用替代药物进行临床试验。
Purpose.Ceftriaxone is the drug of choice for typhoid fever and the emergence of resistantSalmonellaTyphi raises major concerns for treatment. There are an increasing number of sporadic reports of ceftriaxone-resistantS. Typhi and limiting the risk of treatment failure in the patient and outbreaks in the community must be prioritized. This study describes the use of whole genome sequencing to guide outbreak identification and case management.Methodology.An isolate of ceftriaxone-resistantS. Typhi from the blood of a child taken in 2000 at the Popular Diagnostic Center, Dhaka, Bangladesh was subjected to whole genome sequencing, using an Illumina NextSeq 500 and analysis using Geneious software.Results/Key findings.Comparison with other ceftriaxone-resistantS. Typhi revealed an isolate from the Democratic Republic of the Congo in 2015 as the closest relative but no evidence of an outbreak. A plasmid belonging to incompatibility group I1 (IncI1-ST31) which includedblaCTX-M-15(ceftriaxone resistance) associated withISEcp-1was identified. High similarity (90 %) was seen with pS115, an IncI1 plasmid fromS. Enteritidis, and with pESBL-EA11, an incI1 plasmid fromE. coli(99 %) showing thatS.Typhi has access to ceftriaxone resistance through the acquisition of common plasmids.Conclusions.The transmission of ceftriaxone resistance fromE. colitoS.Typhi is of concern because of clinical resistance to ceftriaxone, the main stay of typhoid treatment. Whole genome sequencing, albeit several years after the isolation, demonstrated the success of containment but clinical trials with alternative agents are urgently required.