Endemicity and diversification of carbapenem-resistant Acinetobacter baumannii in an intensive care unit.
Endemicity and diversification of carbapenem-resistant Acinetobacter baumannii in an intensive care unit.
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DOI：
10.1016/j.lanwpc.2023.100780
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发表时间：
2023-08
影响因子：
7.1
通讯作者：
Yu, Yunsong
中科院分区：
文献类型：
--
作者：
Doughty, Emma L.;Liu, Haiyang;Moran, Robert A.;Hua, Xiaoting;Ba, Xiaoliang;Guo, Feng;Chen, Xiangping;Zhang, Linghong;Holmes, Mark;van Schaik, Willem;Mcnally, Alan;Yu, Yunsong
关键词：
耐碳青霉烯类鲍曼不动杆菌（CRAB）是全球主要的公共卫生问题。经常在医院爆发的情况下进行研究，很少有人知道地方性CRAB种群的持久性和进化动力学。在中国杭州的一个28床重症监护病房（ICU）进行了一项为期三个月的横断面观察性研究。从医院环境（n = 3985）、患者（n = 964）和工作人员（n = 119）中共采集了5068份样本。从这些样本的10.5%（n = 532）中获得CRAB分离株。所有这些分离株，加上另外19个来自临床感染的分离株，都通过全基因组测序进行了表征。ICU CRAB人群主要由产OXA-23的全球克隆2分离株（占所有分离株的99.3%）组成，通过基因组测序可将其分为20个不同的簇。CRAB持续存在于ICU中，由定期引入不同的集群驱动。医院环境受到严重污染，在183/335（54.6%）次采样中从床单位分离出CRAB，但仅在72/299（24.1%）次采样中从患者分离出CRAB。CRAB扩散到相邻的床单元和房间，并在ICU内重新定位患者。我们还观察到三个水平的基因转移事件之间的CRAB菌株在ICU，涉及三种不同的质粒。在这种情况下，CRAB的流行病学与先前描述的高收入国家的克隆性暴发形成对比，突出了环境CRAB水库在ICU流行病学中的重要性，以及在这种重要的多药耐药病原体流行的ICU中遏制CRAB传播的独特挑战。这项工作是由（MR/S 013660/1），（81861138054，32011530116，31970128，31770142），（2020 RC 075）和赠款（2018 YFE 0102100）资助的DETECTIVE研究项目的一部分。W. v. S也得到了a（WM 160092）的支持。
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a major public health concern globally. Often studied in the context of hospital outbreaks, little is known about the persistence and evolutionary dynamics of endemic CRAB populations. A three-month cross-sectional observational study was conducted in a 28-bed intensive care unit (ICU) in Hangzhou, China. A total of 5068 samples were collected from the hospital environment (n = 3985), patients (n = 964) and staff (n = 119). CRAB isolates were obtained from 10.5% of these samples (n = 532). All of these isolates, plus an additional 19 from clinical infections, were characterised through whole-genome sequencing. The ICU CRAB population was dominated by OXA-23-producing global clone 2 isolates (99.3% of all isolates) that could be divided into 20 distinct clusters, defined through genome sequencing. CRAB was persistently present in the ICU, driven by regular introductions of distinct clusters. The hospital environment was heavily contaminated, with CRAB isolated from bed units on 183/335 (54.6%) sampling occasions but from patients on only 72/299 (24.1%) occasions. CRAB was spread to adjacent bed units and rooms, and following re-location of patients within the ICU. We also observed three horizontal gene transfer events between CRAB strains in the ICU, involving three different plasmids. The epidemiology of CRAB in this setting contrasted with previously described clonal outbreaks in high-income countries, highlighting the importance of environmental CRAB reservoirs in ICU epidemiology and the unique challenges in containing the spread of CRAB in ICUs where this important multidrug-resistant pathogen is endemic. This work was undertaken as part of the DETECTIVE research project funded by the (MR/S013660/1), (81861138054, 32011530116, 31970128, 31770142), (2020RC075), and the grant (2018YFE0102100). W.v.S was also supported by a (WM160092).
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影响因子：
14.9
作者：
Tonkin-Hill, Gerry;Lees, John A.;Corander, Jukka
通讯作者：
Corander, Jukka
影响因子：
3.9
作者：
Roberts LW;Forde BM;Hurst T;Ling W;Nimmo GR;Bergh H;George N;Hajkowicz K;McNamara JF;Lipman J;Permana B;Schembri MA;Paterson D;Beatson SA;Harris PNA
通讯作者：
Harris PNA
影响因子：
3.7
作者：
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--
DOI：
10.1073/pnas.2013515118
发表时间：
2021-01-05
影响因子：
11.1
作者：
Oldenkamp R;Schultsz C;Mancini E;Cappuccio A
通讯作者：
Cappuccio A
影响因子：
3.9
作者：
Schultz MB;Pham Thanh D;Tran Do Hoan N;Wick RR;Ingle DJ;Hawkey J;Edwards DJ;Kenyon JJ;Phu Huong Lan N;Campbell JI;Thwaites G;Thi Khanh Nhu N;Hall RM;Fournier-Level A;Baker S;Holt KE
通讯作者：
Holt KE