在新生儿Klebsiella oxytoca复杂爆发管理期间解释全基因组测序数据
Chiara Minotti1,2,3, Elena Robinson4,5,6, Pascal Schlaepfer7
1Infectious Disease and Vaccinology Unit and Paediatric Research Centre, University Children's Hospital Basel UKBB, Spitalstrasse 33, Basel, 4031, Switzerland. chiara.minotti@ukbb.ch.
Antimicrobial resistance and infection control
|July 2, 2025
概括
全基因组测序 (WGS) 在新生儿重症监护室 (NICU) 发现了多个Klebsiella oxytoca疫情. 尽管源头被移除,但持续的WGS监测对于管理持续传播和实施感染预防和控制措施至关重要.
科学领域:
- 微生物学 微生物学
- 基因组学就是基因组学.
- 传染病流行病学 传染病流行病学
背景情况:
- 克莱布西拉氧化物 (K. oxytoca) 通常具有较低的毒性,但可以在脆弱的新生儿中引起严重的感染.
- 新生儿重症监护室 (NICU) 是机会性病原体爆发的敏感环境.
- 全基因组测序 (WGS) 为跟踪细菌进化和传播提供了先进的功能.
研究的目的:
- 用WGS. 在瑞士NICU中调查K. oxytoca长期爆发,使用WGS.
- 了解K. oxytoca在爆发期间的基因组进化和传播动态.
- 评估以WGS为指导的疫情应对措施对类似情景的影响.
主要方法:
- 从NICU中分离的临床和环境K. oxytoca的回顾性分析.
- 全基因组测序 (WGS) 在Illumina平台 (MiSeq或NextSeq 500) 上进行.
- 基因组数据使用Ridom SeqSphere进行分析,遵循ORION报告准则.
主要成果:
- WGS确定了两个不同的K. oxytoca爆发波 (ST18野生型和ST18 K1OXY-hyperproducer) 与多个并发的集群.
- 四名早产婴儿患有K. oxytoca败血症;双胞胎表现出相同的ST,但具有不同的耐药性表型.
- 环境测量系统 (WGS) 与环境采样相结合,确切地确定了一个环境来源,但在移除后,传输仍然存在.
结论:
- 在NICU疫情中,WGS有效地支持识别和消除环境源.
- 仅标准的感染预防和控制 (IPC) 措施可能不足以制因持续传播而导致的疫情.
- 建议进行持续的WGS监测,以检测和管理NICU中无处不在的物种同时发生的多次爆发.
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