Multilocus Sequence Typing Analysis of Carbapenem-Resistant Acinetobacter baumannii in a Chinese Burns Institute.
Multilocus Sequence Typing Analysis of Carbapenem-Resistant Acinetobacter baumannii in a Chinese Burns Institute.
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中国烧伤研究所耐碳青霉烯类鲍曼不动杆菌多位点序列分型分析
DOI：
10.3389/fmicb.2016.01717
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发表时间：
2016
影响因子：
5.2
通讯作者：
Peng Y
中科院分区：
文献类型：
--
作者：
Huang G;Yin S;Gong Y;Zhao X;Zou L;Jiang B;Dong Z;Chen Y;Chen J;Jin S;Yuan Z;Peng Y
鲍曼不动杆菌是引起医院感染的主要病原体。耐碳青霉烯类A.鲍曼不动杆菌（CRAB）已经没有多少有效的抗生素可供临床医生使用。为了研究CRAB菌株之间的时间进化关系，我们收集了248株CRAB菌株从中国烧伤研究所超过3年。聚合酶链反应检测OXA-23基因的流行情况。采用多位点序列分型技术对CRAB菌株进行分型，并采用eBURST技术分析其进化关系。伤口表面（41%）、尿道（24%）、导管（15%）和血液（14%）是四个主要的隔离源。除米诺环素（33.5%）和舒巴坦/头孢哌酮（74.6%）外，16种抗生素的耐药率均>90%。248株分离株分为26个序列类型（ST），其中9个已知ST和17个未知ST。这些分离株中的大多数（230/248）属于克隆复合物92（CC 92），包括属于7个未报告ST的8个分离株。发现了一种新的CC，其中包含11株分离株，分为4种新的ST。OXA-23基因在CRAB分离株中以高流行率检测到，并且在各种ST中的流行率不同。大多数分离株显示出密切的进化关系，表明严重的医院传播和医院感染的CRAB发生在烧伤病房。总之，在3年研究期间，该中国烧伤病房CRAB的主要CC保持不变，并确定了一个新的CC。CC 92是优势复合物，应更多地关注监测我们在此确定的新CC。
Acinetobacter baumannii is a leading pathogen responsible for nosocomial infections. The emergence of carbapenem-resistant A. baumannii (CRAB) has left few effective antibiotics for clinicians to use. To investigate the temporal evolutionary relationships among CRAB strains, we collected 248 CRAB isolates from a Chinese burns institute over 3 years. The prevalence of the OXA-23 gene was detected by polymerase chain reaction. Multilocus sequence typing was used to type the CRAB strains and eBURST was used to analyze their evolutionary relationships. Wound surfaces (41%), sputa (24%), catheters (15%), and bloods (14%) were the four dominant isolation sources. Except for minocycline (33.5%) and sulbactam/cefoperazone (74.6%), these CRAB strains showed high resistance rates (>90%) to 16 tested antibiotics. The 248 isolates fall into 26 sequence types (STs), including nine known STs and 17 unknown STs. The majority (230/248) of these isolates belong to clonal complex 92 (CC92), including eight isolates belonging to seven unreported STs. A new CC containing 11 isolates grouped into four new STs was identified. The OXA-23 gene was detected at high prevalence among the CRAB isolates and the prevalence rate among the various STs differed. The majority of the isolates displayed a close evolutionary relationship, suggesting that serious nosocomial spreading and nosocomial infections of CRAB have occurred in the burn unit. In conclusion, the main CC for CRAB in this Chinese burn unit remained unchanged during the 3-year study period, and a new CC was identified. CC92 was the dominant complex, and more attention should be directed toward monitoring the new CC we have identified herein.