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在患有囊性纤维化症的患者中,对linezolid耐药黄金葡萄球菌的并行演变

Nicholas J Pitcher¹, Andries Feder², Nicholas Bolden³

¹Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine , Iowa City, Iowa, USA.

Microbiology spectrum

|September 19, 2023

概括

黄金葡萄球菌 (Staphylococcus aureus) 中的林氏素抗性很少见,但在复发性抗生素暴露后的囊性纤维化患者中可能出现. 多种遗传机制,包括核糖体突变和突变,有助于这种耐药性.

科学领域:

微生物学微生物学
遗传学遗传学是一个
传染性疾病传染性疾病

背景情况:

囊性纤维化 (CF) 患者经常经历持久的金黄色葡萄球菌感染,需要广泛的抗生素治疗.
林氏素是一种关键的抗生素,用于严重感染,包括由MRSA引起的感染.
在CF患者中,反复暴露于线索的情况引起了人们对抗生素耐药性的潜在出现的担忧.

研究的目的:

在CF患者队列中确定对线化物耐药MRSA的发病率.
确定CF患者S. aureus中对线化物耐药性的基础分子机制.
调查S. aureus中耐药性的遗传基础,从用linezolid治疗的患者中分离出来.

主要方法:

追溯鉴定2008年至2018年期间用linezolid治疗的CF患者.
使用微稀释,对S. aureus分离物的微生物学分析,以检测linezolid易感性.
全基因组测序用于遗传学分析和对抗性转移突变或基因的识别.

主要成果:

在接受线索利德治疗的111名CF患者中,有4名患有线索利德耐药性黄金色细菌.
线化物耐药性与特定的遗传背景 (ST5或ST105) 有关.
在三名患者的23S rRNA中鉴定了G2576T突变; 一名患者患有由于mutS/mutL损失而导致多个核糖体突变的超突变菌株.

结论:

在CF患者中,通过不同的遗传途径,可以出现对线胺耐药的金黄色细菌.
机制包括常见的核糖体RNA突变和突变的新组合在高突变菌株.
虽然耐药性似乎是短暂的,但长期暴露于线化物可能会促进未来的耐药性发展.

关键词:

在MRSA中,MRSA可能是MRSA.黄金葡萄球菌黄金葡萄球菌过度突变是一种超级突变.在线zolidlid是什么意思这是一种核糖体RNA.

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