Circulation of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli of Pandemic Sequence Types 131, 648, and 410 Among Hospitalized Patients, Caregivers, and the Community in Rwanda.
Circulation of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli of Pandemic Sequence Types 131, 648, and 410 Among Hospitalized Patients, Caregivers, and the Community in Rwanda.
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DOI：
10.3389/fmicb.2021.662575
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发表时间：
2021
影响因子：
5.2
通讯作者：
Schaufler K
中科院分区：
文献类型：
--
作者：
Eger E;Heiden SE;Korolew K;Bayingana C;Ndoli JM;Sendegeya A;Gahutu JB;Kurz MSE;Mockenhaupt FP;Müller J;Simm S;Schaufler K
多重耐药（MDR）、革兰氏阴性肠杆菌科，如大肠杆菌（E.大肠杆菌）限制了治疗选择并增加了发病率、死亡率和全球范围内的治疗成本。它们对医疗保健系统构成了严重负担，特别是在卢旺达等发展中国家。几项研究表明，产超广谱β-内酰胺酶（ESBL）的大肠杆菌在全球范围内的传播所造成的影响。杆菌然而，关于这些病原体的传播动态及其在撒哈拉以南非洲临床和社区场所携带的移动的因素的数据有限。本研究共检测了120株产ESBL大肠杆菌。来自布塔雷（卢旺达）大学教学医院住院患者、其主治护理人员以及相关社区成员和牲畜的大肠杆菌菌株。以全基因组分析为基础，对遗传多样性和重复遗传学进行了评价。此外，对携带质粒的含量进行了表征和研究，以确定菌株之间的假定传播，以及它们作为抗生素耐药性传播驱动因素的潜在作用。我们发现，在检测到的30种不同序列类型（ST）中，流行性克隆谱系ST 131、ST 648和ST 410将高水平的抗菌素耐药性与毒力联合收割机结合在一起。除了经常发现的抗性基因blaCTX-M-15、泰特（34）和aph（6）-Id之外，我们还鉴定了csg基因，其是卷曲纤维合成和因此生物膜形成所需的。许多菌株携带多个毒力相关基因（VAGs），包括pap（P菌毛粘附簇）、fim（I型菌毛）和chu（Chu血红素摄取系统）。此外，我们发现了来自患者及其护理人员或相关社区成员和动物的菌株之间的系统发育关系，这表明病原体的传播。此外，我们证明了存在和潜在的转移相同/相似的ESBL-质粒在不同的菌株从卢旺达设置和相比时，外部质粒。这项研究强调了临床相关的，致病性产ESBL大肠杆菌的循环。在卢旺达的病人、护理人员和社区中传播大肠杆菌。除了细菌病原体之间移动的遗传元件的假定交换之外，抗菌素耐药性与毒力的结合在世界各地构成了重大风险。
Multi-drug resistant (MDR), gram-negative Enterobacteriaceae, such as Escherichia coli (E. coli) limit therapeutic options and increase morbidity, mortality, and treatment costs worldwide. They pose a serious burden on healthcare systems, especially in developing countries like Rwanda. Several studies have shown the effects caused by the global spread of extended-spectrum beta-lactamase (ESBL)-producing E. coli. However, limited data is available on transmission dynamics of these pathogens and the mobile elements they carry in the context of clinical and community locations in Sub-Saharan Africa. Here, we examined 120 ESBL-producing E. coli strains from patients hospitalized in the University Teaching Hospital of Butare (Rwanda), their attending caregivers as well as associated community members and livestock. Based on whole-genome analysis, the genetic diversification and phylogenetics were assessed. Moreover, the content of carried plasmids was characterized and investigated for putative transmission among strains, and for their potential role as drivers for the spread of antibiotic resistance. We show that among the 30 different sequence types (ST) detected were the pandemic clonal lineages ST131, ST648 and ST410, which combine high-level antimicrobial resistance with virulence. In addition to the frequently found resistance genes blaCTX–M–15, tet(34), and aph(6)-Id, we identified csg genes, which are required for curli fiber synthesis and thus biofilm formation. Numerous strains harbored multiple virulence-associated genes (VAGs) including pap (P fimbriae adhesion cluster), fim (type I fimbriae) and chu (Chu heme uptake system). Furthermore, we found phylogenetic relationships among strains from patients and their caregivers or related community members and animals, which indicates transmission of pathogens. Also, we demonstrated the presence and potential transfer of identical/similar ESBL-plasmids in different strains from the Rwandan setting and when compared to an external plasmid. This study highlights the circulation of clinically relevant, pathogenic ESBL-producing E. coli among patients, caregivers and the community in Rwanda. Combining antimicrobial resistance with virulence in addition to the putative exchange of mobile genetic elements among bacterial pathogens poses a significant risk around the world.
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DOI：
10.1016/j.ijantimicag.2020.106019
发表时间：
2020-07-01
影响因子：
10.8
作者：
Bodendoerfer, Elias;Marchesi, Martina;Mancini, Stefano
通讯作者：
Mancini, Stefano
影响因子：
10.7
作者：
Escobar-Páramo, P;Clermont, O;Denamur, E
通讯作者：
Denamur, E
影响因子：
1.7
作者：
Bankevich, Anton;Nurk, Sergey;Pevzner, Pavel A.
通讯作者：
Pevzner, Pavel A.
影响因子：
3.3
作者：
Carroll, Makeda;Rangaiahagari, Ashok;Ogbuagu, Onyema
通讯作者：
Ogbuagu, Onyema
影响因子：
4.6
作者：
Decano, Arun Gonzales;Downing, Tim
通讯作者：
Downing, Tim