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在以色列的一项多中心研究中,产生NDM的Acinetobacter baumannii的临床和分子特征

Amos Adler^1,2, Hiren Ghosh³, Andrea Gross³

¹Clinical Microbiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. amosa@tlvmc.gov.il.

Annals of clinical microbiology and antimicrobials

|June 30, 2023

概括

新德里产生金属β-乳糖酶的Acinetobacter baumannii (NDMAb) 感染在临床上与其他耐卡巴胺的Acinetobacter baumannii (CRAb) 感染相似. NDMAb的传播主要是通过医疗机构内的克隆传播发生.

科学领域:

医学微生物学医学微生物学
传染性疾病传染性疾病
基因组学就是基因组学.

背景情况:

新德里 Metallo-beta-lactamase 生产的 Acinetobacter baumannii (NDMAb) 感染在全球范围内正在出现,但它们的流行病学,临床表现和传播动态仍然不明.
鉴定NDMAb的特征对于在医疗机构制定有效的感染控制策略至关重要.

研究的目的:

研究NDMAb感染的流行病学,临床特征和微生物特征.
阐明以色列医疗中心内NDMAb的传播网络和分子流行病学.

主要方法:

一项回顾性研究,将NDMAb病例与以色列三家医疗中心的非NDM碳烯耐药Acinetobacter baumannii (CRAb) 病例进行比较.
用核心基因组单核酸多态 (SNP) 距离来定义克隆传播 (≤5 SNP和重叠的住院时间) 的基因组学分析.

主要成果:

NDMAb占CRAb病例的很小一部分 (54/857),其中一个中心的患病率更高 (12.6%).
NDMAb患者的临床特征和风险因素与非NDM CRAb患者相似,住院死亡率相似,但住院时间较长的趋势.
最常见的是blaNDM-2等位基因,其次是blaNDM-1和blaNDM-4,这些异位基因通常由序列类型 (ST) 联系在一起,并且位于保存的移动遗传环境中. 在大多数在医院获得的NDMAb感染中,克隆传播是明显的.

结论:

在临床上,NDMAb感染与其他CRAb感染无法区分,这些病例中所占比例很小.
克隆传播是医疗机构内NDMAb传播的主要方式,这凸显了针对性感染控制措施的必要性.

关键词:

这种细菌是Acinetobacter baumannii.碳烯的使用方法没有NDM,没有NDM.传输传输传输传输整个基因组测序的测序

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