PDF(Pubmed)
Abstract：
Carbapenem-resistant Acinetobacter baumannii (CRAb) is an important pathogen causing serious nosocomial infections. We describe an outbreak of CRAb in an intensive care unit in the Netherlands in 2021. During an outbreak of non-resistant A. baumannii, while infection control measures were in place, CRAb isolates carrying highly similar bla NDM-1 - and tet(x3)-encoding plasmids were isolated from three patients over a period of several months. The chromosomal and plasmid sequences of the CRAb and non-carbapenemase-carrying A. baumannii isolates cultured from patient materials were analysed using hybrid assemblies of short-read and long-read sequences. The CRAb isolates revealed that the CRAb outbreak consisted of two different strains, carrying similar plasmids. The plasmids contained multiple antibiotic resistance genes including the tetracycline resistance gene tet(x3), and the bla NDM-1 and bla OXA-97 carbapenemase genes. We determined minimal inhibitory concentrations (MICs) for 13 antibiotics, including the newly registered tetracycline antibiotics eravacycline and omadacycline. The CRAb isolates showed high MICs for tetracycline antibiotics including eravacycline and omadacycline, except for minocycline which had a low MIC. In this study we show the value of sequencing multidrug-resistant A. baumannii for outbreak tracking and guiding outbreak mitigation measures.
摘要：
耐碳青霉烯类鲍曼不动杆菌(CRAb)是引起严重医院感染的重要病原菌。我们描述了2021年荷兰重症监护病房CRAb的爆发。在非耐药鲍曼不动杆菌爆发期间，在感染控制措施到位的同时，在几个月的时间内，从三名患者中分离出携带高度相似的blaNDM-1和tet（x3）编码质粒的CRAb分离株。使用短读和长读序列的混合组装分析了从患者材料培养的CRAb和非碳青霉烯酶携带鲍曼不动杆菌分离株的染色体和质粒序列。CRAb分离株显示，CRAb爆发由两种不同的菌株组成，携带类似的质粒。质粒含有多种抗生素抗性基因，包括四环素抗性基因tet（x3），和blaNDM-1和blaOXA-97碳青霉烯酶基因。我们确定了13种抗生素的最低抑制浓度（MIC），包括新注册的四环素类抗生素埃拉环素和奥马环素。CRAb分离株对包括埃拉环素和奥马环素在内的四环素类抗生素显示出较高的MIC，除了米诺环素具有低MIC。在这项研究中，我们展示了对多重耐药鲍曼不动杆菌进行测序对疫情跟踪和指导疫情缓解措施的价值。
