山东省潍坊市农村居民耐碳青霉烯类阴沟肠杆菌耐药基因特征及核心基因组特征分析  

Analysis of gene characteristics and core genome characteristics of carbapenem-resistant Enterobacter cloacae in rural residents of Weifang City,Shandong Province

作　　者：王安阁 王爽[2] 刘璐 孙高翔 陈玉贞[2] 齐加新 寇增强[2] 毕振旺 Wang Ange;Wang Shuang;Liu Lu;Sun Gaoxiang;Chen Yuzhen;Qi Jiaxin;Kou Zengqiang;Bi Zhenwang(Hospital Infection Management Office,Provincial Hospital Affiliated to Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250021,China;Infectious Disease Control Center,Shandong Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东第一医科大学(山东省医学科学院)附属省立医院医院感染管理办公室,济南250021 [2]山东省疾病预防控制中心传染病防制所,济南250014

出　　处：《中华预防医学杂志》2024年第1期48-55,共8页Chinese Journal of Preventive Medicine

基　　金：山东省重点研发计划(2017GSF218062);山东省医药卫生科技发展计划(2017WS447);山东省医药卫生科技发展计划(202112071042);国家科技重大专项(2018ZX10713003-002);国家科技重大专项(2018ZX10714002-003)。

摘　　要：目的探究山东省潍坊市农村居民耐碳青霉烯类阴沟肠杆菌(CR-ECL)耐药基因特征及核心基因组特征。方法收集2017年山东省潍坊市农村社区居民粪便标本,使用耐碳青霉烯类肠杆菌显色培养基筛选耐药菌株,通过激光解吸/电离飞行时间质谱仪(MALDI-TOFMS)分析获得CR-ECL阳性菌株,针对CR-ECL分离株,采用微量肉汤稀释法进行抗生素敏感性试验获得CR-ECL耐药表型,开展全基因组测序(WGS)和分析、bla_(NDM)基因周围环境及菌株间系统进化分析。结果共获得并检测628份粪便标本,6份为CR-ECL阳性(检出率0.96%),均表现为多重耐药(MDR)表型。6株CR-ECL共有4个MLST分型(ST),均携带多种耐药基因(bla_(NDM-1)、bla_(NDM-5)等)和毒力基因(acrA、acrB、entB、fepC等),且bla_(NDM)基因周围遗传环境中均存在移动遗传元件ISAba125、TN3-IS3000、TN3及IS5。系统发育树显示,核心基因组多位点序列分型(core genome multilocus sequence typing,cgMLST)与单核苷酸多态性(SNPs)结果具有一致性,cgMLST结果显示菌株2BC0101B与2BC0251B,2BG0561B与2BI0221B之间等位基因差异分别为2和1,SNPs结果显示上述2对菌同样各自聚成一簇,并发现美国国立生物技术信息中心数据库(National Center for Biotechnology Information,NCBI)中鸡粪样本的菌株居于进化树中心,且本地序列均可追溯到美国人源序列。结论山东省潍坊市农村社区居民中已检出多重耐药碳青霉烯类阴沟肠杆菌。Objective To investigate the drug-resistant gene characteristics and core genome characteristics of carbapenem-resistant Enterobacter cloacae(CR-ECL)in rural residents of Weifang City,Shandong Province.Methods Fecal samples were collected from rural community residents in Weifang City,Shandong Province in 2017.Drug-resistant strains were screened using a carbapenem-resistant enterobacter chromogenic medium.CR-ECL positive strains were acquired via Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry(MALDI-TOFMS)analysis.The antibiotic resistance phenotype of CR-ECL was determined using a microbroth dilution assay.Whole genome sequencing(WGS)and analysis were conducted,along with an examination of the immediate vicinity of the bla_(NDM)gene and phylogenetic analysis of the strains.Results A total of 628 fecal samples were collected and tested,of which 6 were CR-ECL positive(detection rate 0.96%),all exhibiting multiple drug resistance(MDR)phenotypes.Six CR-ECL strains had four MLST genotypes(ST),all of which carried multiple drug resistance genes(bla_(NDM-1),bla_(NDM-5),etc.)and virulence genes(acrA,acrB,entB,fepC,etc.).There were mobile genetic elements ISAba125,TN3-IS3000,TN3 and IS5 in the genetic environment surrounding the bla_(NDM)gene.The phylogenetic tree showed that the multi-locus sequence typing of the core genome(cgMLST)was consistent with the single nucleotide polymorphism(SNPs)results.The cgMLST results showed that the allele differences between strains 2BC0101B and 2BC0251B,2BG0561B and 2BI0221B were 2 and 1,respectively.The SNPs results showed that the above two pairs of bacteria also clustered together.It was found that the strains of chicken fecal samples in the National Center for Biotechnology Information(NCBI)database were located in the center of the evolutionary tree,and the local sequences could be traced back to American human sequences.Conclusion Multidrug-resistant CR-ECL is detected in rural community residents in Weifang City,Shandong Province.

关 键 词：基因组 细菌 碳青霉烯类耐药 阴沟肠杆菌 

分 类 号：R446.5[医药卫生—诊断学]