基于全基因组测序技术分析深圳市人民医院2008—2016年碳青霉烯类耐药大肠埃希菌的耐药基因及分子流行病学特征  

Genetic characteristics of carbapenem-resistant Escherichia coli isolates based on whole genome sequencing analysis in Shenzhen People′s Hospital,2008-2016

作　　者：林豪芸 梁训宏 胡珍 卢月梅 吴劲松 吴文苑 Lin Haoyun;Liang Xunhong;Hu Zhen;Lu Yuemei;Wu Jinsong;Wu Wenyuan(Department of Clinical Laboratory,Shenzhen People′s Hospital,Shenzhen 518000,China)

机构地区：[1]深圳市人民医院检验科,深圳518000

出　　处：《中华检验医学杂志》2020年第11期1086-1092,共7页Chinese Journal of Laboratory Medicine

基　　金：深圳市科技创新委员会(JCYJ20160422151142150)。

摘　　要：目的:用全基因组测序技术分析深圳市人民医院2008—2016年碳青霉烯类耐药大肠埃希菌(CR-ECO)的耐药基因构成情况及相关分子流行病学特征。方法:收集深圳市人民医院2008年1月1日至2016年12月31日的CR-ECO菌株,采用改良碳青霉烯类失活法和EDTA碳青霉烯类失活法进行表型确证,并采用llumina HiSeq进行二代测序,分析其耐药基因及相关分子生物学特征。结果:共收集CR-ECO非重复菌株16株,经过全基因组测序发现携带IMP-4基因5株,IMP-26基因1株,NDM-1基因1株,NDM-5基因4株,NDM-13基因2株。16株菌株中检测出AmpC酶和(或)超广谱β内酰胺酶(ESBL)基因及各类外排泵基因,11株CR-ECO出现OmpC膜孔蛋白基因缺失;多位点序列分型、血清学分型呈多样化。结论:深圳市人民医院2008—2016年CR-ECO的耐药机制主要以产IMP型或NDM型碳青霉烯酶同时合并AmpC酶和(或)ESBL为主。利用全基因组测序可快速了解菌株在基因水平上的分子生物学信息。Objective Whole genome sequencing(WGS)technology was used to analyze resistance genes and epidemiological characteristics of carbapenem-resistant Escherichia coli(CR-CEO)in Shenzhen People′s Hospital from 2008 to 2016.Methods During January 1,2008 to December 31,2016,CR-ECO isolated from Shenzhen People′s Hospital were collected.Carbapenem-resistant phenotypes were confirmed by mCIM and eCIM.Simultaneous Next-generation sequencing was performed using llumina HiSeq to analyze resistance genes and related molecular biological characteristics of strains.Results A total of 16 non-repeating strains of CR-ECO were collected,13 isolates showed carbapenemase encoding genes through WGS analysis,including blaIMP-4(n=5),blaIMP-26(n=1),blaNDM-1(n=1),blaNDM-5(n=4),and blaNDM-13(n=2).The AmpC enzyme genes,extended-spectrumβ-lactamase genes,and various efflux pump genes were detected in some of the 16 strains,and 11 strains of CR-ECO showed deletion of the OmpC membrane porin gene;MLST and serological typing are diversified.Conclusions The resistance mechanism of CR-ECO in Shenzhen People′s Hospital from 2008 to 2016 was mainly based on the production of IMP or NDM carbapenemase combined with AmpC enzyme or extended-spectrumβ-lactamase.The molecular biological information of pathogenic microbiology can be obtained quickly by WGS.

关 键 词：卡巴配能类 大肠杆菌 Β-内酰胺酶类 耐碳青霉烯类肠杆菌科 全基因组测序 分子流行病学 

分 类 号：R446.5[医药卫生—诊断学]