某农村社区奇异变形杆菌耐药特征及遗传进化分析  

Characterizing drug resistance and analyzing genetic evolution of Proteus mirabilis in a rural community

作　　者：张芸 王爽[2] 寇增强[2] 刘璐 孙高翔 纪龙 陈玉贞[2] ZHANG Yun;WANG Shuang;KOU Zengqiang;LIU Lu;SUN Gaoxiang;JI Long;CHEN Yuzhen(Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan,Shandong 250117,China;Shandong Provincial Center for Disease Control and Prevention,Jinan,Shandong 250014,China)

机构地区：[1]山东第一医科大学(山东省医学科学院),山东济南250117 [2]山东省疾病预防控制中心,山东济南250014

出　　处：《中国热带医学》2024年第11期1357-1362,共6页China Tropical Medicine

基　　金：山东省医药卫生科技项目(No.202312050986);山东省公共卫生学会科研项目(No.SGWXH202326);山东省青年创新基金项目(No.QC-202306)。

摘　　要：目的探究山东省潍坊市诸城农村健康人群、动物及环境来源奇异变形杆菌(Proteus mirabilis,PM)的分子流行病学特征。方法2023年11月从山东省潍坊市诸城健康人群、动物粪便及污水样本中分离的奇异变形杆菌进行药物敏感性试验。通过全基因组测序的方法,揭示blaNDM-1耐药基因周围遗传环境,通过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(single nucleotide polymorphism,SNP)分析探究菌株间遗传进化关系。结果共采集人粪便样本840份、动物粪便样本336份、污水48份,PM阳性率分别为3.21%、0.89%、2.08%。PM对美罗培南(96.97%)、厄他培南(96.97%)、头孢他啶(84.85%)、头孢他啶/阿维巴坦(90.91%)、替加环素(100.00%)较为敏感。共检测出抗生素耐药基因54种,tet(J)(81.81%)、cat(81.81%)检出率较高,其中2株污水来源PM同时携带blaNDM-1与bla_(OXA-1)耐药基因。blaNDM-1基因周围存在IS91、ISVsa3及IS6插入序列。污水来源分离株(E3DJ004、C3DJ004)与5pro、16pro(2017,中国,人)等位基因及SNP差异数仅为69,具有较高遗传同一性。3BF020和3BH05801,3BK028、3BL044和3BL045关系密切(等位基因及SNP差异数<3),均为人来源的PM,SNP结果与cgMLST结果一致。结论虽然本研究PM对碳青霉烯类药物依然敏感,但其携带耐药基因较多。为防止耐药基因的隐匿传播,应加强人群、动物及环境等多来源样本的耐药性监测,防止耐药菌在“人-动物-环境”界面传播扩散。Objective To investigate the molecular epidemiological characteristics of Proteus mirabilis from healthy populations,animals,and environmental sources in rural areas of Zhucheng,Weifang City,Shandong Province,China.Methods In this study,drug susceptibility testing was conducted on Proteus mirabilis isolated from healthy populations,animal feces,and sewage samples in Zhucheng,Weifang City,Shandong Province,China.The genetic environment surrounding the blaNDM-1 resistance gene was elucidated through whole-genome sequencing,and the genetic evolutionary relationships among strains were investigated through core genome multilocus sequence typing(cgMLST)and single nucleotide polymorphism(SNP)analysis.Results A total of 840 human fecal samples,336 animal fecal samples,and 48 sewage samples were collected;the positivity rates were 3.21%,0.89%,and 2.08%,respectively.Proteus mirabilis(PM)showed high sensitivity to meropenem(96.97%),ertapenem(96.97%),ceftazidime(84.85%),ceftazidime/avibactam(90.91%),and tigecycline(100%).A total of 54 antibiotic resistance genes were identified,with high detection rates of tet(J)(81.81%)and cat(81.81%).Two sewage-sourced PM strains carried both blaNDM-1 and bla_(OXA-1)resistance genes.The blaNDM-1 gene was flanked by IS91,ISVsa3,and IS6 insertion sequences.The sewage-derived isolates(E3DJ004,C3DJ004)and alleles such as 5pro,16pro(2017,China,human)had only 69 SNP differences,indicating high genetic similarity.Strains(3BF020,3BH05801)and(3BK028,3BL044,3BL045)were closely related(allelic and SNP differences<3),all of human origin,with SNP results consistent with cgMLST results.Conclusions Although PM in this study remains sensitive to carbapenems,it carries a greater number of drug-resistant genes.To prevent the undetected dissemination of drug-resistant genes,monitoring of multisource samples from humans,animals,and the environment should be strengthened,to prevent the spread of drug-resistant bacteria at the"human-animal-environment"interface.

关 键 词：奇异变形杆菌 耐药基因 新德里金属β-内酰胺酶 全基因组测序 

分 类 号：R372[医药卫生—病原生物学]