ヒトに感染する多剤耐性非結核菌の出現と拡散
Josephine M Bryant1,2, Dorothy M Grogono2,3, Daniela Rodriguez-Rincon2
1Wellcome Trust Sanger Institute, Hinxton, UK.
Science (New York, N.Y.)
|November 16, 2016
まとめ
多剤耐性菌であるMycobacterium abscessusによる肺感染症のほとんどは 人から人へと感染するのであり 環境から感染するわけではありません これらの感染株は 胞性線維症の患者を悪化させ 緊急の世界的な健康問題をもたらします
科学分野:
- 微生物学
- 感染症
- ゲノミクス
背景:
- 非結核性ミコバクテリア (NTM) の肺感染症は,特に cystic fibrosis (CF) の患者において,懸念が高まっている.
- Mycobacterium abscessus (M. abscessus) は多剤耐性のNTMで,肺損傷を悪化させ,CFの罹病率と死亡率を増加させる.
- 以前は,M. abscessusの獲得は主に環境への曝露に起因していました.
研究 の 目的:
- M.アブセサス単離体の伝播ダイナミクスとゲノム特性を調査する.
- 異なるM.abscessus獲得経路と循環するクローンの臨床的影響を決定する.
- 支配的なM.アブセサス菌株の毒性と世界的な拡散を評価する.
主な方法:
- 全ゲノムシーケンシングと臨床M.アブセサス単離物の総合収集の分析.
- 流通中の支配的なクローンを特定するための比較ゲノム分析
- ウイルス性評価のための細胞ベースのインビトロおよびインビボマウス感染モデル.
- 感染パターンの流行病学的分析
主要な成果:
- 大半のM.abscessusの感染は人間から人間に感染するだけでなく,環境から感染する.
- 主要な循環するクローンは,フォミットやエアロゾールを介して潜在的に拡散し,ほとんどの感染の原因になります.
- これらの世界的に広がったクローンは,患者での臨床結果の悪化と関連しています.
- 実験モデルで示されたように,これらの支配的なクローンは他の株と比較して毒性が増加しています.
結論:
- M. アブセサス感染は,特にCF患者では,毒性のクローンの広範囲にわたる伝染による緊急の国際的課題です.
- 感染経路を理解することは,M.アブセススの流行を制御するために非常に重要です.
- 薬剤耐性のNTMの拡散を追跡し管理するために,ゲノム監視は不可欠です.
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