新型冠状病毒感染大流行前后ICU环境中鲍曼不动杆菌同源性分析  

Homology analysis of Acinetobacter baumannii in intensive care unit before and after COVID-19 pandemic

作　　者：王筱 梁艳茹 张悦 陆湘华[2] 丰俊 王远萍[2] 赵冰[1] WANG Xiao;LIANG Yan-ru;ZHANG Yue;LU Xiang-hua;FENG Jun;WANG Yuan-ping;ZHAO Bing(Microbiological Laboratory,Shanghai Pudong New Area Center for Disease Control and Prevention,Shanghai 200136,China;Department of Disinfection and Infection Control,Shanghai Pudong New Area Center for Disease Control and Prevention,Shanghai 200136,China;Institute of Microbiology Laboratory,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市浦东新区疾病预防控制中心微生物检测实验室,上海200136 [2]上海市浦东新区疾病预防控制中心消毒与感染控制科,上海200136 [3]上海市疾病预防控制中心病原生物检定所,上海200336

出　　处：《中国感染控制杂志》2024年第10期1213-1219,共7页Chinese Journal of Infection Control

基　　金：上海市加强公共卫生体系建设三年行动计划(2023-2025年)重点学科(GWVI-11.1-02);上海市浦东新区疾病预防控制中心科技项目(PDCDC-KJ-2024-06)。

摘　　要：目的探究新型冠状病毒感染大流行前后上海市部分医疗机构重症监护病房(ICU)环境中病原菌的分布及鲍曼不动杆菌同源性变化情况。方法采用基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)法分离鉴定病原菌,通过Illumina Miseq测序平台对鲍曼不动杆菌进行全基因组测序,基于多位点序列分型(MLST)和核心基因组MLST(cgMLST)探讨其亲缘关系。结果大流行后ICU环境中病原菌总检出率(6.10%,101/1656)低于大流行前(10.77%,181/1680;P<0.05)。大流行前后,ICU环境中检出的鲍曼不动杆菌在被褥表面占比均维持在最高水平,但大流行后ST型呈多样性分布。MLST_Pasteur结果显示,162株鲍曼不动杆菌分为20种ST型,以ST2(80.25%,130株)为主;MLST_Oxford结果显示,162株菌株共有19种ST型,以ST208(37.04%,60株)为主;基于cgMLST的聚类分析结果显示,大流行后ST208_Oxford与ST540_Oxford和ST369_Oxford的亲缘关系更接近,ST164_Pasteur克隆由大流行前的ST234_Oxford转变为大流行后的ST1418_Oxford,新发现2种新型ST_Pasteur和11种新型ST_Oxford。结论大流行后ICU环境中病原菌检出率低于大流行前,大流行前后相同分离位点ST型分布略有不同,大流行前后的流行克隆仍以ST2_Pasteur/ST208_Oxford为主,但部分等位基因发生了改变,cgMLST在同源性分析、进化与传播、暴发分析方面的精确度优于MLST_Oxford和MLST_Pasteur。Objective To investigate the distribution of pathogens and change of homology of Acinetobacter baumannii(AB)in intensive care units(ICUs)of partial medical institutions in Shanghai before and after the pandemic of coronavirus disease 2019(COVID-19).Methods Pathogens were isolated and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS),the whole genome of AB was sequenced using Illumina Miseq sequencing platform,and its genetic relationship was explored based on multilocus sequence typing(MLST)and core genome multilocus sequence typing(cgMLST).Results The total detection rate of pathogens in ICU environment after the pandemic was lower than before the pandemic([6.10%,101/1656]vs[10.77%,181/1680];P<0.05).Before and after the pandemic,the proportion of AB detected on the surface of bedding in the ICU environment remained at the highest level.After the pandemic,the ST types showed a diverse distribution.MLST_Pasteur results showed that 162 strains of AB were divided into 20 ST types,with ST2(80.25%,n=130)being the main type.MLST_Oxford results showed that there were 19 ST types among 162 strains,with ST208(37.04%,n=60)being the main type.The clustering analysis based on cgMLST showed that ST208_Oxford had closer genetic relationship with ST540_Oxford and ST369_Oxford after the pandemic.ST164_Pasteur clone changed from ST234_Oxford before the pandemic to ST1418_Oxford after the pandemic,and 2 new types of ST_Pasteurr and 11 new types of ST_Oxford were discovered.Conclusion The detection rate of pathogens from ICU environment after the pandemic is lower than before the pandemic,and the distribution of ST types is slightly different at the same detection sites before and after the pandemic.ST2_Pasteur/ST208_Oxford is still the dominant epidemic clone before and after the pandemic,but some alleles have changed.cgMLST is more accurate than MLST_Oxford and MLST_Pasteur in homology analysis,evolution,spread,and outbreak analysis.

关 键 词：新型冠状病毒感染 鲍曼不动杆菌 ST型 同源性分析 重症监护病房环境 

分 类 号：R181.32[医药卫生—流行病学] R378[医药卫生—公共卫生与预防医学]