Whole-Genome Analysis of an Extensive Drug-Resistant Acinetobacter Baumannii ST195 Isolate from a Recipient After DCD Renal Transplantation in China
Whole-Genome Analysis of an Extensive Drug-Resistant Acinetobacter Baumannii ST195 Isolate from a Recipient After DCD Renal Transplantation in China
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DOI：
10.1159/000485928
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发表时间：
2017-12
影响因子：
2.8
通讯作者：
Hong Jiang;Luxi Cao;Qixia Shen;L. Qu;Yan Jiang;Ting-ting Qu;Jian Zhang;Ying-ying Lu;Bingjue Li;Chaohong Zhu;Guangjun Liu;Rending Wang;Miao Chen;Yu-cheng Wang;Yanfei Wang;Shi Feng;Junwen Wang;Yunsong Yu;Jianyong Wu;Jianghua Chen
中科院分区：
文献类型：
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作者：
Hong Jiang;Luxi Cao;Qixia Shen;L. Qu;Yan Jiang;Ting-ting Qu;Jian Zhang;Ying-ying Lu;Bingjue Li;Chaohong Zhu;Guangjun Liu;Rending Wang;Miao Chen;Yu-cheng Wang;Yanfei Wang;Shi Feng;Junwen Wang;Yunsong Yu;Jianyong Wu;Jianghua Chen
背景/目的：鲍曼不动杆菌感染已成为心脏死亡移植捐献后死亡的主要原因之一。方法：我们报告一例接受DCD肾移植后感染鲍曼不动杆菌的病例。临床对药敏试验结果进行验证。采用全基因组分析方法在基因水平上探讨抗性机制。结果：术后第1天从患者引流液中分离出病原菌，药敏试验显示对替加环素敏感。然而，从引流液中获得的分离物在给予替加环素15天后变得耐药。药敏试验结果表明，病原菌从对替加环素的耐药性中恢复过来，转为对替加环素的中间体。全基因组分析揭示了导致替加环素耐药的遗传水平变化，并通过比较分离株的全基因组序列确定了突变的位置。发现了3个可能与耐药有关的基因座，包括编码HTH结构域蛋白、MFS转运蛋白和AdeS的基因。结论：了解病原菌耐药机制的遗传特征和抗菌谱对控制感染暴发和预防严重并发症具有重要意义，并为抗菌药物的开发提供了新的思路。
Background/Aims: Infection with Acinetobacter baumannii was emerging as one of the leading causes of mortality after donation after cardiac death transpalantion. Methods: We reported a case of a recipient who underwent DCD renal transplantation and later got infected by A.baumannii. Etests were done to verify the susceptibility test results in clinic. Whole-genome analysis was applied to investigate the resistant mechanism at gene level. Results: The pathogen was isolated from his draining liquid the day after the surgery, and susceptibility test reavealed that it was sensitive to tigecycline. However, the isolate obtained from the draining liquid became tigecycline-resistant after fifteen-day administration of tigecycline. The Susceptibility tests showed that the pathogen recovered from tigecycline resistance and became intermediated to tigecycline. Whole-Genome analysis revealed the genetic level change leading to tigecycline resistance and we identified the location of mutation by comparing the whole genome sequence of the isolates. Three loci were figured out which may contribute to drug resistance, including genes encoding HTH domain protein, MFS transporter and AdeS. Conclusion: Understanding the genetic characteristics associated with drug resistance mechanism and antimicrobial profiles of pathogen is important in controlling infection outbreak and preventing serious complications and gives a new insight into the development of antimicrobial agents.