Characterization of carbapenem-resistant Acinetobacter baumannii isolates in a Chinese teaching hospital.
Characterization of carbapenem-resistant Acinetobacter baumannii isolates in a Chinese teaching hospital.
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中国某教学医院耐碳青霉烯类鲍曼不动杆菌的特征
DOI：
10.3389/fmicb.2015.00910
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发表时间：
2015
影响因子：
5.2
通讯作者：
Ling B
中科院分区：
文献类型：
--
作者：
Chang Y;Luan G;Xu Y;Wang Y;Shen M;Zhang C;Zheng W;Huang J;Yang J;Jia X;Ling B
碳青霉烯类耐药鲍曼不动杆菌 (CRAB) 提出了严峻的治疗和感染控制挑战。在本研究中，我们调查了中国西部某医院 CRAB 的流行病学和分子差异以及导致 CRAB 感染增加的威胁因素。最近 2 年收集的总共 110 株鲍曼不动杆菌临床分离株进行了碳青霉烯类抗生素敏感性测试，随后进行了碳青霉烯酶基因的分子分析。通过多位点序列分型来表征分离株的遗传相关性。 110个分离株中的67个（60.9%）对碳青霉烯类药物耐药，其中80.60%（54/67）携带blaOXA-23基因。这些 CRAB 分离株中的大多数 (77.62%) 被归类为克隆复合体 92 (CC92)，序列类型 (ST) 92 是最常见的 ST，其次是 ST195、ST136、ST843 和 ST75。 ST195 的一株 CRAB 分离株携带来自一名无旅行史的中国患者的质粒 pAB52。该质粒含有与生长适应相关的毒素-抗毒素元件，这可能是间接介导 OXA-23 在 CRAB 中传播的常见载体。因此，携带OXA-23的CC92鲍曼不动杆菌是在中国传播的主要耐药菌株。我们的研究结果表明，合理应用抗生素对于最大限度地减少耐药性的广泛传播是必不可少的。
Carbapenem-resistant Acinetobacter baumannii (CRAB) presents a serious therapeutic and infection control challenge. In this study, we investigated the epidemiological and molecular differences of CRAB and the threatening factors for contributing to increased CRAB infections at a hospital in western China. A total of 110 clinical isolates of A. baumannii, collected in a recent 2-year period, were tested for carbapenem antibiotic susceptibility, followed by a molecular analysis of carbapenemase genes. Genetic relatedness of the isolates was characterized by multilocus sequence typing. Sixty-seven of the 110 isolates (60.9%) were resistant to carbapenems, 80.60% (54/67) of which carried the blaOXA-23 gene. Most of these CRAB isolates (77.62%) were classified as clone complex 92 (CC92), and sequence type (ST) 92 was the most prevalent STs, followed by ST195, ST136, ST843, and ST75. One CRAB isolate of ST195 harbored plasmid pAB52 from a Chinese patient without travel history. This plasmid contains toxin–antitoxin elements related to adaptation for growth, which might have emerged as a common vehicle indirectly mediating the spread of OXA-23 in CRAB. Thus, CC92 A. baumannii carrying OXA-23 is a major drug-resistant strain spreading in China. Our findings indicate that rational application of antibiotics is indispensable for minimizing widespread of drug resistance.