肠外致病性大肠埃希菌/ST88和鼠伤寒沙门菌单相变种/ST34双菌血症菌株基因组学特征  

Genomic characteristics of extraintestinal pathogenic Escherichia coli/ST88 and monophasic Salmonella Typhimurium/ST34 in a patient with double bacteremia

作　　者：朱旻 裴宇航 王闻卿 陈瑜 刘红 王亚楠 许学斌[4] Zhu Min;Pei Yuhang;Wang Wenqing;Chen Yu;Liu Hong;Wang Yanan;Xu Xuebin(Department of Laboratory Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China;International Joint Research Center of National Animal Immunology,College of Veterinary Medicine,Henan Agricultural University,Zhengzhou 450046,China;Department of Microbiology,Pudong New Area Center for Disease Control and Prevention,Shanghai 200136,China;Division of Pathogen Testing and Analysis,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]复旦大学附属华山医院检验医学科,上海200040 [2]河南农业大学动物医学院,国家动物免疫学国际联合研究中心,郑州450046 [3]上海市浦东新区疾病预防控制中心微生物检验科,上海200136 [4]上海市疾病预防控制中心病原生物检定所,上海200336

出　　处：《中华医学杂志》2025年第13期1023-1027,共5页National Medical Journal of China

基　　金：国家重点研发计划(2023YFC2307101、2017YFC1600100)。

摘　　要：分析肠外致病性大肠埃希菌(ExPEC)/序列型(ST)88和鼠伤寒沙门菌单相变种(MST)/ST34双菌血症菌株基因组学特征。回顾性分析2024年7月25日上海华山医院收治的1例女性患者临床资料,临床诊断为软组织感染继发盆腔脓肿、肺部感染及双菌血症。菌株经全基因组测序结果为ExPEC/ST88和MST/ST34,分别对8类15种和10类18种抗菌药物耐药。ResFinder和CARD数据库预测两株菌有12种耐药机制或微结构存在不同程度重叠或交叉。ExPEC/ST88有19种84个毒力基因。MST/ST34有27种150个毒力基因。先后给予利奈唑胺葡萄糖注射液、亚胺培南西司他汀、美罗培南抗感染治疗后患者体温恢复正常。ExPEC/ST88为本例患者血流感染主要病原,为临床少见案例,叠加黏菌素耐药MST的病例更罕见,ExPEC/ST88具有高耐药、高毒力、高重组的人兽共患与食源性侵袭性疾病特征。To analyze the genomic characteristics of patients with double bacteremia caused by extraintestinal pathogenic Escherichia coli(ExPEC)/sequence type(ST)88 and monophasic Salmonella Typhimurium(MST)/ST34.The clinical data of a female patient admitted to Shanghai Huashan Hospital on July 25,2024 were retrospectively analyzed,and the clinical diagnosis was pelvic abscess secondary to soft tissue infection,pulmonary infection and double bacteremia.The whole-genome sequencing results of the strains were ExPEC/ST88 and MST/ST34,respectively,with resistance to 15 antibiotics belonging to 8 classes for ExPEC/ST88 and 18 antibiotics belonging to 10 classes for MST/ST34.ResFinder and CARD database predicted that 12 resistance mechanisms or microstructures of the two strains overlapped or crossed to varying degrees.ExPEC/ST88 had 84 virulence genes in 19 species.MST/ST34 had 150 virulence genes in 27 species.The patient′s temperature returned to normal after anti-infection treatment with linezolid and glucose injection,imipenem and cistatin,and meropenem successively.ExPEC/ST88 is the primary pathogen causing bloodstream infection in this patient,marking the first case reported in Asia,and the coexistence with colistin-resistant MST makes this case even more rare.ExPEC/ST88 has the characteristics of high antibiotic resistance,high virulence,and high recombination of zoonotic and foodborne invasive diseases.

关 键 词：菌血症 大肠埃希菌 沙门菌 基因组 序列型 

分 类 号：R378[医药卫生—病原生物学]