在ICU环境中的多药耐药病原体的季节性基因组动力学以及对基干预的前景
Yan Zhang1, Xiaoyu Li2, Fengli Wang3
1Medical Intensive Care Unit (MICU), Central Hospital Affiliated to Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, 116033, People's Republic of China.
在重症监护室的多药耐药病原体显示季节性基因组变异. 了解这些模式是开发针对抗生素耐药性的适应性感染控制策略的关键.
科学领域:
- 微生物学 微生物学
- 基因组学就是基因组学.
- 传染性疾病 传染性疾病
背景情况:
- 重症监护病房 (ICU) 面临着多药耐药 (MDR) 病原体的日益严重威胁,导致高死亡率.
- 耐卡巴尼姆的 *Klebsiella pneumoniae* 和 *Acinetobacter baumannii* 特别涉及到MDR病原体.
- 观察到的抗微生物耐药性模式的季节性波动缺乏全面的基因组解释.
研究的目的:
- 调查来自ICU的细菌分离物中耐药性基因患病率的季节性变异.
- 阐明基因组特征有助于观察到全年抗菌素耐药性模式.
主要方法:
- 在不同季节从ICU收集环境和临床样本的系统采集.
- 使用Illumina和纳米孔平台对细菌分离物的全基因组测序.
- 使用CARD,VFDB和BiocideResistance数据库对抗性基因的注释;统计分析和家族遗传评估.
主要成果:
- *bla*CTX-M-3基因在秋季分离物中普遍存在,与增加床位交换和消毒间隔 (p=0.003) 有关.
- 冬季分离显示高发病率的 * qacEΔ1 * (75%),与多药性耐药性和克隆扩张,增强的生物膜形成,并上调排泄 (p=0.02) 相关.
- *aac(6') -Ib7*是最常见的抗药性基因 (68%),这表明抗生素选择压力很大.
结论:
- 在ICU耐药病原体中,独特的季节性基因组模式需要适应性感染控制策略.
- 有针对性的消毒,抗生素管理和菌体治疗 (特别是在冬季) 可以对抗抗性克隆传播.
- 需要进一步的体外和体内验证,以确认拟议的策略的有效性.
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