在萨格勒布的一家医院引起VIM-1和VIM-4阳性Proteus mirabilis的爆发
Branka Bedenić1,2, Gernot Zarfel3, Josefa Luxner3
1Biomedical Research Institute-BIMIS, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
Pathogens (Basel, Switzerland)
|August 28, 2025
概括
在克罗地亚的一家精神病院发生了耐卡巴胺Proteus mirabilis (CRPM) 疫情. 这些广泛耐药 (XDR) 的CRPM分离物产生VIM-1和VIM-4金属β-乳酸酶,限制了治疗选择.
科学领域:
- 临床微生物学和传染病
- 抗菌药物耐药性
- 分子流行病学
背景情况:
- 虫是尿道和伤口感染的常见原因.
- 对扩展频谱头素 (ESC) 的耐药性是由ESBL或p-AmpC介导的.
- 由于碳胺酶的产生,耐碳胺P.mirabilis (CRPM) 的出现构成重大威胁.
研究的目的:
- 在克罗地亚萨格勒布的一家精神病院调查CRPM感染的爆发.
- 描述与疫情相关的P.奇迹菌分离物的抗菌性机制.
主要方法:
- 使用磁盘扩散和稀释方法进行抗生素敏感性测试.
- 使用表型测试 (DDST,MHT,CIM,eCIM) 查ESBL,p-AmpC和卡巴酶.
- 对抗性基因 (VIM-1,VIM-4,blaCTX-M-15,blaTEM) 的分子鉴定和等离子体表征 (PBRT,WGS).
主要成果:
- 分析了20个CRPM分离物,这些分离物对多种抗生素,包括ESC和卡巴胺具有耐药性.
- 表型测试表明ESBL的产生和金属β-乳糖酶 (MBL) 的活性.
- 通过PCR和WGS检测出了VIM-1和VIM-4碳酶,以及blaCTX-M-15,blaTEM以及各种氨基糖化物,硫胺,trimethoprim,氨基醇和四环素耐药基因.
结论:
- 在一家精神病院发现了CRPM的流行,其特点是具有广泛耐药性 (XDR) 的表型.
- 存在VIM-1和VIM-4碳酶导致治疗选择有限.
- 这项研究是克罗地亚首次报告产生卡巴酶的P. mirabilis.
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