Wide distribution of CC92 carbapenem-resistant and OXA-23-producing Acinetobacter baumannii in multiple provinces of China
Wide distribution of CC92 carbapenem-resistant and OXA-23-producing Acinetobacter baumannii in multiple provinces of China
复制标题
耐CC92碳青霉烯类且产OXA-23的鲍曼不动杆菌在中国多个省份广泛分布
DOI：
10.1016/j.ijantimicag.2013.06.019
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发表时间：
2013-10-01
影响因子：
10.8
通讯作者：
Yu, Yunsong
中科院分区：
文献类型：
--
作者：
Ruan, Zhi;Chen, Yan;Yu, Yunsong
耐碳青霉烯类鲍曼不动杆菌在中国迅速传播，目前据报道已成为全球医院的威胁。鉴于其日益增加的临床意义，本研究旨在调查从中国多个省份获得的碳青霉烯类耐药和敏感菌株的分子流行病学。根据临床和实验室标准协会（CLSI）指南，通过纸片扩散法测定抗菌药物敏感性。采用多位点序列分型（MLST）方法对分离株进行分子流行病学调查。此外，最小生成树算法被应用到聚类序列类型（ST）到克隆复合物（CC），以分析它们的进化相关性。碳青霉烯类抗生素耐药菌株除米诺环素（20.45%）外，其余大多数抗生素的平均耐药率都很高（>85%）。MLST数据分析证实，碳青霉烯类耐药菌株的遗传背景相对简单，ST 92是最流行的克隆，在每个省都有出现，其次是ST 138、ST 75和ST 381。相比之下，碳青霉烯类药物敏感的分离株具有更多样化的遗传背景。此外，碳青霉烯类耐药分离株中分布最广的CC是bla（OXA-23）样产生型，主要是CC 92，其中包含ST 136及其几种单基因座变体。有趣的是，与其他ST相比，属于CC 92的菌株具有更高的抗生素耐药率。总体而言，这些观察结果表明，碳青霉烯类耐药和bla（OXA-23）样产生克隆CC 92的广泛分布，特别是ST 92、ST 75和ST 138，是中国碳青霉烯类耐药率迅速增加的主要原因。(C)2013年爱思唯尔B。和国际化疗学会。All rights reserved.
Carbapenem-resistant Acinetobacter baumannii has spread rapidly across China and is currently reported to be a worldwide nosocomial menace. In light of its increasing clinical significance, this study aimed to investigate the molecular epidemiology of carbapenem-resistant and carbapenem-susceptible isolates obtained from multiple provinces of China. Antimicrobial susceptibility was determined by disk diffusion assay according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Multilocus sequence typing (MLST) was used to investigate the molecular epidemiology of the isolates. In addition, a minimum spanning tree algorithm was applied to cluster sequence types (STs) into clonal complexes (CCs) in order to analyse their evolutionary relatedness. Generally, the average rate of resistance to most antibiotics in carbapenem-resistant isolates was extremely high (>85%), except for minocycline (20.45%). Analysis of MLST data confirmed that the genetic background of carbapenem-resistant isolates was relatively simple, with ST92 being the most prevalent clone, occurring in every province, followed by ST138, ST75 and ST381. In contrast, carbapenem-susceptible isolates had a more diverse genetic background. Furthermore, the most widely distributed CC of carbapenem-resistant isolates was bla(OXA-23)-like-producing and predominantly CC92, which incorporate ST136 and its several single-locus variants. Interestingly, isolates belonging to CC92 possessed higher antibiotic resistance rates compared with other STs. Overall, these observations suggest a wide distribution of carbapenem-resistant and bla(OXA-23)-like-producing clone CC92, especially ST92, ST75 and ST138, as the principal reason for the rapidly increasing carbapenem resistance rate in China. (C) 2013 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.