血流感染来源鲍曼不动杆菌耐药和毒力基因的分析  

Analysis of drug resistance and virulence genes of Acinetobacter baumannii in blood stream infections

作　　者：王婧婧 毛旭建 赵莹 杜强[2] 屠博文[2] 王凤鸣 黎俊宏[1,2] WANG Jingjing;MAO Xujian;ZHAO Ying;DU Qiang;TU Bowen;WANG Fengming;LI Junhong(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Department of Physical and Chemical Laboratory,Changzhou Center for Disease Control and Prevention,Changzhou 213022,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]常州市疾病预防控制中心理化检验科,江苏常州213022

出　　处：《现代医学》2024年第4期523-529,共7页Modern Medical Journal

基　　金：常州市“十四五”卫生健康高层次人才培养工程(拔尖)(2022CZBJ099);常州市应用基础研究计划(中资助)(CJ20200105)。

摘　　要：目的:采用全基因组测序(WGS)技术分析血流感染(BSI)来源鲍曼不动杆菌(Ab)的耐药和毒力基因及两者间的关系。方法:选取2021年12月到2023年6月常州市某三甲医院BSI来源Ab菌株25株进行WGS,使用基因组流行病学中心(CGE)的ResFinder4.0程序解析其耐药基因,R软件制作热图;在PubMLST(https://pubmlst.org/)上进行多位点序列分型(MLST)和全基因组多位点序列分型(cgMLST),CSIPhylogeny1.4和FigTreev1.4.4软件绘制最大似然树(MLT),用ITOL(https://itol.embl.de)工具美化并分析其同源性,SPSS 26.0软件分析不同毒力基因耐药性差异。结果:25株Ab有20株属我国常见的ST2,其余为ST2266、ST25、ST106、ST1917、ST1641。25株Ab共检测出28种获得性耐药基因。25株菌株均携带blaADC-25,除编号为S1、S4、S10、S12、S24这5株菌株,其余均携带碳青霉烯酶耐药基因blaOXA-23和blaOXA-66,每个菌株的耐药基因分布不同,其中β-内酰胺酶耐药基因被携带的菌株数量最多。25株Ab均携带多种毒力因子,包括外膜孔蛋白、脂多糖、生物膜、外排泵、磷脂酶等毒力因子。毒力基因abaI、galE阳性菌株与阴性菌株在部分抗生素中的耐药性差异有统计学意义(P<0.05)。结论:该院Ab的耐药性、毒力特征复杂多样,携带不同毒力基因的菌株之间耐药性存在差异。Objective:To analyze the relationship between the drug resistance and virulence genes of Acinetobacter baumannii(Ab)in blood stream infections by using whole genome sequencing(WGS).Methods:Twenty-five BSI-derived Ab strains from a tertiary hospital in Changzhou City were selected for WGS from December 2021 to June 2023.Strain resistance genes were analyzed by using ResFinder 4.0 from the Center for Genomic Epidemiology(CGE).Heat maps were produced using R software.Multilocus sequence typing(MLST)and genome-wide multilocus sequence typing(cgMLST)were performed on PubMLST(https:∥pubmlst.org/).Maximum likelihood trees were plotted by CSIPhylogeny1.4 and FigTreev1.4.4 software,while ITOL(https:∥itol.embl.de)tool to beautify and analyze the homology.Differences in drug resistance across virulence genes were analyzed by using SPSS 26.0.Results:Among the 25 Ab strains,20 strains belonged to common ST2,and the rest were ST2266,ST25,ST106,ST1917,ST1641.28 acquired resistance genes were detected in the 25 strains.25 strains of Ab were all carrying bla ADC-25,and all of them were carrying the carbon-based resistance genes bla OXA-23 and bla OXA-66,except for 5 strains,which were numbered as S1,S4,S10,S12,and S24.Penicillinase resistance genes bla OXA-23 and bla OXA-66,the distribution of resistance genes varied for each strain,with the highest number ofβ-lactamase resistance genes being carried by these strains.All 25 strains carried multiple virulence factors,including outer membrane pore proteins,lipopolysaccharides,biofilms,efflux pumps,phospholipases,and other virulence factors.There were statistic differences in some antibiotics drug resistance of strains with virulence genes abaI and galE or without.Conclusion:The drug resistance and virulence characteristics of Ab are complex and diverse,as well as there are differences in resistance between strains carrying different virulence genes.

关 键 词：鲍曼不动杆菌 血流感染 耐药基因 毒力基因 

分 类 号：R378[医药卫生—病原生物学]