Abstract：
Gram-negative bacteria (GNB) continue to develop resistance against important antibiotics including last-resort ones such as carbapenems and polymyxins. An analysis of GNB with co-resistance to carbapenems and polymyxins from a One Health perspective is presented. Data of species name, country, source of isolation, resistance genes (ARGs), plasmid type, clones and mobile genetic elements (MGEs) were deduced from 129 articles from January 2016 to March 2021. Available genomes and plasmids were obtained from PATRIC and NCBI. Resistomes and methylomes were analysed using BAcWGSTdb and REBASE whilst Kaptive was used to predict capsule typing. Plasmids and other MEGs were identified using MGE Finder and ResFinder. Phylogenetic analyses were done using RAxML and annotated with MEGA 7. A total of 877 isolates, 32 genomes and 44 plasmid sequences were analysed. Most of these isolates were reported in Asian countries and were isolated from clinical, animal and environmental sources. Colistin resistance was mostly mediated by mgrB inactivation (37%; n = 322) and mcr-1 (36%; n = 312), while OXA-48/181 was the most reported carbapenemase. IncX and IncI were the most common plasmids hosting carbapenemases and mcr genes. The isolates were co-resistant to other antibiotics, with floR (chloramphenicol) and fosA3 (fosfomycin) being common; E. coli ST156 and K. pneumoniae ST258 strains were common globally. Virulence genes and capsular KL-types were also detected. Type I, II, III and IV restriction modification systems were detected, comprising various MTases and restriction enzymes. The escalation of highly resistant isolates drains the economy due to untreatable bacterial infections, which leads to increasing global mortality rates and healthcare costs.
摘要：
革兰氏阴性菌（GNB）继续对重要的抗生素产生耐药性，包括最后的抗生素，例如碳青霉烯类和多粘菌素。从一个健康的角度分析了对碳青霉烯类和多粘菌素具有共同抗性的GNB。物种名称的数据，国家,隔离源,抗性基因（ARGs），质粒类型,从2016年1月至2021年3月的129篇文章中推导出克隆和可移动遗传元件(MGEs)。从PATRIC和NCBI获得可用的基因组和质粒。使用BAcWGSTdb和REBASE分析抗性组和甲基化组,而Kaptive用于预测胶囊分型。使用MGEFinder和ResFinder鉴定质粒和其他MEG。使用RAxML进行系统发育分析并用MEGA7进行注释。共有877个分离株,分析了32个基因组和44个质粒序列。这些分离株大多数是在亚洲国家报告的，是从临床上分离的，动物和环境来源。粘菌素抗性主要由mgrB失活（37％；n=322）和mcr-1（36％；n=312）介导，而OXA-48/181是报道最多的碳青霉烯酶。IncX和IncI是最常见的携带碳青霉烯酶和mcr基因的质粒。这些分离株对其他抗生素有共同耐药性，其中floR(氯霉素)和fosA3(磷霉素)是常见的;大肠杆菌ST156和肺炎克雷伯菌ST258菌株是全球常见的。还检测到毒力基因和荚膜KL型。I型,II,检测到III和IV限制修饰系统，包含各种MTase和限制酶。由于无法治愈的细菌感染，高耐药性分离株的升级耗尽了经济，这导致全球死亡率和医疗保健成本不断上升。
