Whole Genome Analysis of Extensively Drug-Resistant Acinetobacter baumannii Clinical Isolates in Thailand
Whole Genome Analysis of Extensively Drug-Resistant Acinetobacter baumannii Clinical Isolates in Thailand
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DOI：
10.2174/1871526520999201116201911
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发表时间：
2021-01-01
影响因子：
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通讯作者：
Hamada, Shigeyuki
中科院分区：
文献类型：
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作者：
Chopjitt, Peechanika;Kerdsin, Anusak;Hamada, Shigeyuki
背景：鲍曼不动杆菌是引起医院获得性感染的主要条件致病菌。广泛耐药鲍曼不动杆菌（XDRAB）的流行率不断增加，已成为医疗机构日益关注的问题，由于治疗选择的限制，已阻碍了公共卫生，并与高发病率和死亡率以及住院时间延长相关。高度多药耐药A.鲍曼不动杆菌将增加对耐药机制、新型耐药的出现、分离株之间的遗传关系、来源追踪和选定患者的治疗决策的了解。目的：本研究揭示了基因组分析，以探索携带bla（OXA-23）的XDRAB分离株在泰国。方法：在HiSeq 2000 Illumina平台上对两种XDRAB分离株进行全基因组测序，并进行抗菌药物敏感性分析。这两个分离株揭示了国际，克隆II携带，多重抗菌素耐药基因-ST 195和ST 451的序列类型。他们对不动杆菌属检测的所有药物类别中的抗菌药物均具有耐药性。它们携带18种抗菌药物耐药基因，包括4种β-内酰胺酶基因（bla（OXA-）（23）、bla（OXA-66）、bla（ADC-）（25））、4个氨基糖苷类耐药基因（阿尔马、aph（32-la、aph（3“）-lb、aph（6）-Id）、3个大环内酯类耐药基因（amvA、mphE、msrE）、1个磺胺类耐药基因（sul-2）、2个四环素类耐药基因（tetB，tetR），1个耐药-增殖-细胞分裂（RND）抗生素外排泵基因簇，2个主要易化超家族（MFS）抗生素外排泵基因（abaF、abaQ）和1个小的多药耐药（SMR）抗生素外排泵基因（abeS）。结论：全基因组测序结果显示，两株携带bla（OXA-23）的XDRAB菌株均聚在国际克隆II下，具有不同的ST，且携带多种耐药基因，使其对抗菌药物产生耐药性。抗菌药物的灭活、酶的靶向修饰和外排泵的泵送作用是XDRAB的主要耐药机制。
Background: Acinetobacter baumannii is recognized as a majority opportunistic nosocomial pathogen causing hospital-acquired infection worldwide. The increasing prevalence of extensively drug-resistant Acinetobacter baumannii (XDRAB) has become a rising concern in healthcare facilities and has impeded public health due to limitation of therapeutic options and are associated with high morbidity and mortality as well as longer hospitalization. Whole-genoine sequencing of highly multidrug resistant A. baumannii will increase the understanding of resistant mechanisms, the emergence of novel resistance, genetic relationships among the isolates, source tracking, and treatment decisions in selected patients.Objective: This study revealed the genomic analysis to explore bla(OXA-23) harboring XDRAB isolates in Thailand.Methods: Whole-genome sequencing of the two XDRAB isolates was carried out on a HiSeq2000 Illumina platform and susceptibility on antimicrobials was conducted.Results: Both isolates revealed sequence types of international, clone II-carrying, multiple antimicrobial-resistant genes-ST195 and ST451. They were resistant to antimicrobial agents in all drug classes tested for Acinetobacter spp. They carried 18 antimicrobial-resistant genes comprising of 4 beta-lactamase genes (bla(OXA-)(23), bla(OXA-66), bla(ADC-)(25)), 4 aminoglycoside-resistant genes (armA, aph(32-la, aph(3 '')-lb, aph(6)-Id), 3 macrolide-resistant genes (amvA, mphE, msrE), 1 sulfonamide-resistant gene (sul-2), 2 tetracycline-resistant genes (tetB, tetR), 1 resistant-nodulation-cell division (RND) antibiotic efflux pump gene cluster, 2 major facilitator superfamily (MFS) antibiotic efflux pump genes (abaF, abaQ), and 1 small multidrug-resistant (SMR) antibiotic efflux pump gene (abeS). Mutation of g7rA (S81L) occurred in both isolates.Conclusion: Whole-genome sequencing revealed both bla(OXA-23) harboring XDRAB isolates were clustered under international clone II with different STs and carrying multiple antimicrobial-resistant genes conferred their resistance to antimicrobial agents. Inactivation of antimicrobials and target modification by enzymes and pumping antibiotics by efflux pump are mainly resistance mechanism of the XDRAB in this study.