Global emergence of the widespread Pseudomonas aeruginosa ST235 clone
Global emergence of the widespread Pseudomonas aeruginosa ST235 clone
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DOI：
10.1016/j.cmi.2017.06.018
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发表时间：
2018-03-01
影响因子：
14.2
通讯作者：
Hocquet, D.
中科院分区：
文献类型：
--
作者：
Treepong, P.;Kos, V. N.;Hocquet, D.
目的：尽管铜绿假单胞菌具有非克隆性流行种群结构，但仍有多种多位点序列类型分布于世界各地，且常与多药耐药困扰治疗的流行有关。ST235是这些广泛存在的克隆中最普遍的一个。在本研究中，我们旨在了解ST235的起源及其成功的分子基础。方法：对27年来全球收集的79株铜绿假单胞菌的基因组进行分析。我们利用贝叶斯方法建立了一个系统发育网络，并鉴定了抗生素耐药性决定因素和ST235特异性基因。结果：我们的数据表明，ST235亚系在1984年左右出现在欧洲，与氟喹诺酮类药物作为一种抗假瘤药物的引入相吻合。ST235亚系似乎是通过两个独立的克隆从欧洲传播过来的。ST235分离株随后似乎获得了对氨基糖苷类、β-内酰胺类和碳青霉烯类抗生素的耐药性决定因素。此外，我们还发现所有的ST235基因组都含有外毒素编码的外毒素，并鉴定出22个与跨膜外排、DNA加工和细菌转化相关的ST235特异基因。这些独特的基因组合可能导致了与铜绿假单胞菌ST235感染相关的不良结局，并增加了这个国际克隆获得移动耐药元素的能力。结论：我们的数据表明，铜绿假单胞菌ST235(A)已在全球流行，可能是由于氟喹诺酮类药物的选择压力，以及(B)通过突变和在当地人群中获得耐药元素而容易对氨基糖苷类、β-内酰胺类和碳青霉烯类产生耐药性。(C)2017年欧洲临床微生物学和传染病学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: Despite the non-clonal epidemic population structure of Pseudomonas aeruginosa, several multi-locus sequence types are distributed worldwide and are frequently associated with epidemics where multidrug resistance confounds treatment. ST235 is the most prevalent of these widespread clones. In this study we aimed to understand the origin of ST235 and the molecular basis for its success.Methods: The genomes of 79 P. aeruginosa ST235 isolates collected worldwide over a 27-year period were examined. A phylogenetic network was built, using a Bayesian approach to find the Most Recent Common Ancestor, and we identified antibiotic resistance determinants and ST235-specific genes.Results: Our data suggested that the ST235 sublineage emerged in Europe around 1984, coinciding with the introduction of fluoroquinolones as an antipseudomonal treatment. The ST235 sublineage seemingly spread from Europe via two independent clones. ST235 isolates then appeared to acquire resistance determinants to aminoglycosides, beta-lactams and carbapenems locally. Additionally, we found that all the ST235 genomes contained the exoU-encoded exotoxin and identified 22 ST235-specific genes clustering in blocks and implicated in transmembrane efflux, DNA processing and bacterial transformation. These unique combinations of genes may have contributed to the poor outcome associated with P. aeruginosa ST235 infections and increased the ability of this international clone to acquire mobile resistance elements.Conclusion: Our data suggest that P. aeruginosa ST235 (a) has become prevalent across the globe potentially due to the selective pressure of fluoroquinolones and (b) readily became resistant to aminoglycosides, b-lactams and carbapenems through mutation and acquisition of resistance elements among local populations. (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.