| 曲梅,黄瑛,田祎,张新,贾蕾,吕冰,王全意.北京市2010-2020年多重耐药肯塔基沙门菌流行特征分析[J].中华流行病学杂志,2021,42(7):1252-1259 |
| 北京市2010-2020年多重耐药肯塔基沙门菌流行特征分析 |
| Analysis on epidemiological characteristics of multidrug-resistant Salmonella Kentucky in Beijing, 2010-2020 |
| 收稿日期:2020-12-06 出版日期:2021-07-29 |
| DOI：10.3760/cma.j.cn112338-20201206-01382 |
| 中文关键词: 肯塔基沙门菌 多重耐药 耐药基因 全基因组测序 |
| 英文关键词: Salmonella Kentucky Multidrug resistance Resistance genes Whole-genome sequencing |
| 基金项目:国家科技重大专项（2018ZX10714002-003-002） |
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| 摘要点击次数: 1980 |
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| 中文摘要: |
| 目的 了解北京市肯塔基沙门菌临床分离株的流行情况、耐药水平及分子特征。方法 对2010-2020年分离的22株肯塔基沙门菌采用微量肉汤稀释法进行抗生素药物敏感性检测；全基因组测序进行多位点序列分型、基因组岛和耐药基因识别。采用PFGE分析菌株的分子流行病学特征。结果 22株菌对8~22种抗生素耐药，尤其是对环丙沙星、阿奇霉素和头孢菌素类等都表现为超高水平的多重耐药。21株菌超广谱β-内酰胺酶表型阳性。全基因组序列分析显示，22株肯塔基沙门菌均为ST198，携带SGI1-K基因组岛。所有菌株均有耐药基因tetA、sul1、qacE，喹诺酮耐药决定区gyrA基因存在2个突变位点（S83F、D87 N）、parC基因存在3个突变位点（T57S、S80I、T255S）。β-内酰胺类相关耐药基因（blaCTX-M-55、blaCTX-M-14b、blaTEM-141、blaTEM-206、blaTEM-209、blaTEM-214、blaTEM-1B）、氨基糖甙类耐药相关基因[aac（3）-Id、aac（3）-IId、aac（6'）-Iaa、aadA7、aadA17、aph（3'）-Ia、aph（3''）-Ib、aph（6）-Id、rmtB]以及floR、dfrA14、mphA和qnrS1等基因在不同年代菌株间存在明显差异。PFGE图谱分析显示，22株菌株之间相似性>85%，与全球广泛传播的ST198-X1流行株高度同源，在传播扩散过程中，耐药谱和PFGE图谱都发生了变化，分为两大聚类簇。结论 北京市流行的肯塔基沙门菌为多重耐药的ST198-X1-SGI-1K国际流行株，自2016年以来保持低水平流行，引起散发感染病例和聚集性腹泻事件。对氟喹诺酮类、ESBL和阿奇霉素等耐药严重，应加强多重耐药肯塔基沙门菌的监测。 |
| 英文摘要: |
| Objective To investigate the epidemiological, drug resistance and molecular characteristics of Salmonella (S.) Kentucky strains isolated from diarrheal patients in Beijing. Methods The drug susceptibility of 22 S. Kentucky strains isolated in Beijing during 2010-2020 was tested by using the micro broth dilution method. The multilocus sequence typing (MLST), drug resistance genes and Salmonella genomic island (SGI) identifications of the strains were performed by whole-genome sequencing (WGS).The pulsed field gel electrophoresis (PFGE) was performed to analyze the molecular epidemiological characteristics of the isolates. Results The 22 strains were highly resistant to 8-22 kinds of antibiotics, especially to ciprofloxacin, cephalosporins and azithromycin, etc., showing a super high level of multidrug resistance and 21 strains were positive for extended-spetrum beta-lactamase (ESBL). The WGS analysis revealed that all the isolates belonged to ST198, carrying SGI1-K. The drug resistance genes tetA, sul1 and qacE were identified in all strains and Quinolone resistance-determining regions (QRDRs) showed 2 mutations in gyrA (S83F, D87 N) and 3 mutations in the parC gene (T57S, S80I, T255S). The resistance genes associated with β-lactam antibiotics (blaCTX-M-55, blaCTX-M-14b, blaTEM-141, blaTEM-206, blaTEM-209, blaTEM-214, blaTEM-1B), resistance genes associated with aminoglycosides[aac(3)-Id, aac(3)-IId, aac(6')-Iaa, aadA7, aadA17, aph(3')-Ia, aph(3'')-Ib, aph(6)-Id,rmtB] as well as floR, dfrA14, mphA and qnrS1 had significant differences in the strains of different years, which were highly consistent with the drug-resistant phenotype. Furthermore, phylogenetic analysis showed that the similarity of the 22 strains was more than 85%, and the strains were highly homologous to CIP-resistant ST198-X1 circulating in the world. In the process of spread, the drug resistance and PFGE spectrums had changed, two clusters had formed.Conclusions The S. Kentucky strains isolated in Beijing shared high homology with the multidrug-resistant strain ST198-X1-SGI-1K isolated in the world, which has maintained a low level of spread since 2016, causing sporadic infections and clusters of diarrhea, and has serious resistances to fluoroquinolones, ESBLs and azithromycin. The surveillance for multidrug-resistant S. Kentucky should be strengthened. |
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