2018-2021年江苏省不同来源小肠结肠炎耶尔森菌药物敏感性特征分析  

Drug-resistance characteristics of Yersinia enterocolitica from different sources in Jiangsu,2018−2021

作　　者：周璐[1] 程晓庆 段然[2] 袁敏[2] 仲慧[3] 祝雯雯[4] 鲍倡俊[1] 王鑫[2] 姜雪琪 谈忠鸣[1] Zhou Lu;Cheng Xiaoqing;Duan Ran;Yuan Min;Zhong Hui;Zhu Wenwen;Bao Changjun;Wang Xin;Jiang Xueqi;Tan Zhongming(NHC Key Laboratory of Enteric Pathogenic Microbiology,Jiangsu Provincial Centre for Disease Control and Prevention,Nanjing 210009,Jiangsu,China;National Institute for Communicable Disease Prevention and Control,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Dongtai County Centre for Disease Control and Prevention,Dongtai 224299,Jiangsu,China;Xuzhou Prefectural Centre for Disease Control and Prevention,Xuzhou 221002,Jiangsu,China)

机构地区：[1]国家卫生健康委员会肠道病原微生物重点实验室江苏省疾病预防控制中心,江苏南京210009 [2]中国疾病预防控制中心传染病预防控制所,北京102206 [3]东台市疾病预防控制中心,江苏东台224299 [4]徐州市疾病预防控制中心,江苏徐州221002

出　　处：《疾病监测》2022年第9期1223-1229,共7页Disease Surveillance

基　　金：国家科技重大专项(No.2018ZX10713-003-002,No.2018ZX10713-001-002);江苏省卫生健康委科研重点项目(No.ZD2021037)。

摘　　要：目的了解2018—2021年江苏地区间不同来源小肠结肠炎耶尔森菌的耐药表型和耐药基因携带情况。方法收集2018—2021年江苏地区各类标本,进行小肠结肠炎耶尔森菌分离培养鉴定,采用肉汤稀释法对分离株进行9类15种抗菌药物的敏感性测定,将分离株的全基因组序列与抗菌药物抗性基因数据库(CARD)比对,对基因组中的耐药基因进行扫描分析。结果2018—2021年江苏省共采集各类标本6414份,共鉴定出132株小肠结肠炎耶尔森菌,分离率为2.06%,其中47株菌分离自腹泻患者。药敏分析结果显示全部菌株对青霉素类抗菌药物氨苄西林均耐药,对替加环素和阿米卡星全部敏感。对其他12种抗菌药物均有不同的程度的耐药(3.79%~38.64%)。共发现42种药物非敏感表型,66.02%(87/132)的菌株对3类以上抗菌药物非敏感。基因组序列分析发现,菌株共携带8类16种耐药基因,分别是ß-内酰胺酶基因blaA、blaB和blaOXA-10;氨基糖苷类耐药基因aac、aad和aph;喹诺酮类耐药基因qnr;四环素类耐药基因tet;酰胺醇类耐药基因floR、cmlA和cat;磺胺类耐药基因dfrA、qac和sul、链阳菌素类耐药基因vatF和利福霉素类耐药基因arr,携带率范围为0.76%~96.97%。其中32.58%的菌株发生了GYRA 83位氨基酸的突变,介导菌株对喹诺酮类药物的耐药。耐药严重的菌株PIN-YC-2019139携带一个由11个耐药基因和多个转移元件组成的耐药基因簇,提示可移动元件介导了耐药性在小肠结肠炎耶尔森菌株间的转移。结论2018—2021年江苏省监测小肠结肠炎耶尔森菌耐药情况严重,获得性耐药基因的获得和固有基因的突变导致菌株呈现多种药物非敏感谱。耐药基因和可移动元件的嵌合是耐药基因簇加速转移的潜在风险,提示应加强监测和抗菌药物的合理使用,警惕超级耐药菌的出现。Objective To reveal the antimicrobial susceptibility and drug-resistance genes characteristics of Yersinia enterocolitica from different sources in Jiangsu province during 2018-2021. Methods Different kinds of specimens were collected for strain isolation, the isolated strains of Y. enterocolitica were evaluated by biochemical identification. All the isolates were tested for drug susceptibility to 15 kind antibiotics by the broth dilution method. The whole genome sequences of strains were scanned for drug resistance genes by Comprehensive Antibiotic Research Database(CARD). Results From 2018to 2021, a total of 6 414 specimens were collected, and 132 strains(2.06%) of Y. enterocolitica were isolated and identified.Among them, 47 were isolated from diarrhea patients. The results of drug susceptibility analysis showed that all the strains were resistant to macrolide antibiotic azithromycin and penicillin antibiotic ampicillin, and sensitive to tigecycline and amikacin. There were different degrees of resistances(3.79%–38.64%) to 12 other kinds of antibiotics. A total of 42 druginsensitive phenotypes were found, and 65.90%(87/132) of the strains were not sensitive to ≥3 antibiotics. Based on sequencing analysis, 8 types of 16 drug resistance genes were found, i.e. β-lactamase genes bla A, bla B and blaOXA-10, aminoglycoside resistance genes aac, aad and aph, quinolone resistance gene qnr, tetracycline resistance gene tet, amide alcohol resistance gene flo R, cml A and cat, sulfonamide resistance gene dfr A, qac and sul, streptavidin gene vat F and rifamycin resistance gene arr. The carriage rate ranged from 0.76% to 96.97%. Among them, 32.58% of the strains had GYRA83 amino acid mutation, which mediated the resistance of the strains to quinolones. One severely resistant strain(PIN-YC-2019139) carried a resistance gene cluster consisting of 11 resistance genes and multiple transferring elements, suggesting that mobile elements mediate resistance transferring among Y. enterocolitica strains. Conclusion From 2018 t

关 键 词：小肠结肠炎耶尔森菌 血清型 全基因组测序 耐药性 耐药基因 

分 类 号：R211[医药卫生—中医学] R392.12