Carbon-Oxygen Ligases

  • 文章类型: Journal Article
    目的:从野猪粪便样品中检测携带利奈唑胺和万古霉素耐药基因的肠球菌。
    结果:氟苯尼考和万古霉素耐药肠球菌,在选择性琼脂平板上分离,通过PCR筛选利奈唑胺和万古霉素抗性基因的存在。五个分离株携带optrA或poxtA利奈唑胺抗性基因;一个菌株对vanA基因的存在具有万古霉素抗性。测试所有分离株的抗生素敏感性并进行WGS分析。在粪肠球菌(E.粪肠)V1344和V1676,optrA位于新的pV1344-optrA和pV1676-optrA质粒上,分别,而在屎肠球菌(E.faecium)V1339该基因的染色体遗传背景与人屎肠球菌分离物中检测到的基因相同,为22.354bp。在屎肠球菌V1682和durans肠球菌V1343中,PoxtA在先前在人屎肠球菌分离物中发现的p1818-c质粒上。在屎肠球菌V1328中,vanA基因位于Tn1546转座子上,进而位于新的pV1328-vanA质粒上。在过滤器交配测定中,只有屎肠球菌V1682成功地将poxtA基因转移至肠球菌受体。
    结论:野猪肠球菌中携带利奈唑胺和万古霉素抗性基因的遗传元件的出现是一个值得关注的问题,此外,来自野生动物的分离株之间共享质粒和转座子,人类,和环境表明这些环境之间的遗传物质交换。
    OBJECTIVE: To investigate enterococci carrying linezolid and vancomycin resistance genes from fecal samples recovered from wild boars.
    RESULTS: Florfenicol- and vancomycin-resistant enterococci, isolated on selective agar plates, were screened by PCR for the presence of linezolid and vancomycin resistance genes. Five isolates carried optrA or poxtA linezolid resistance genes; one strain was resistant to vancomycin for the presence of vanA gene. All isolates were tested for their antibiotic susceptibility and subjected to Whole Genome Sequencing (WGS) analysis. In Enterococcus faecalis (E. faecalis) V1344 and V1676, the optrA was located on the new pV1344-optrA and pV1676-optrA plasmids, respectively, whereas in Enterococcus faecium (E. faecium) V1339 this gene was on a 22 354-bp chromosomal genetic context identical to the one detected in a human E. faecium isolate. In both E. faecium V1682 and E. durans V1343, poxtA was on the p1818-c plasmid previously found in a human E. faecium isolate. In E. faecium V1328, the vanA gene was on the Tn1546 transposon in turn located on a new pV1328-vanA plasmid. Only E. faecium V1682 successfully transferred the poxtA gene to an enterococcal recipient in filter mating assays.
    CONCLUSIONS: The occurrence of genetic elements carrying linezolid and vancomycin resistance genes in enterococci from wild boars is a matter of concern, moreover, the sharing of plasmids and transposons between isolates from wild animals, human, and environment indicates an exchange of genetic material between these settings.
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  • 文章类型: Journal Article
    背景:这项研究分析了携带带有vanA操纵子的Tn1546型转座子的耐万古霉素屎肠球菌(VREfm)血液分离株的遗传性状和适应性成本。
    方法:在一年的研究期间,从韩国的8家综合医院收集所有屎肠球菌的血液分离株。进行了药敏试验以及vanA和vanBPCR。测定屎肠球菌分离株的生长速率。对vanA阳性分离株进行全基因组测序和缀合实验。
    结果:在308个屎肠球菌分离株中,132(42.9%)为vanA阳性。所有Tn1546型转座子都带有位于质粒上的vanA操纵子,而是在7个分离株的染色体上.带有vanA操纵子的质粒分为四种类型;两种类型的圆形,非共轭质粒(A型,n=50;B型,n=46),和两种类型的假定线性,共轭质粒(C型,n=16;类型D,n=5)。vanA阳性屎肠杆菌的生长速率显著低于vanA阴性菌株(P<0.001),并且在万古霉素压力下生长速率的降低在带有假定的线性质粒的分离株中明显大于带有环状质粒的分离株(P=0.020)。
    结论:在无抗菌环境中,拥有vanA操纵子对细菌宿主来说是昂贵的,这为降低万古霉素压力对预防VREfm传播的重要性提供了证据。细菌宿主的适应性负担因vanA操纵子携带质粒的类型和大小而异。
    BACKGROUND: This study analyzed the genetic traits and fitness costs of vancomycin-resistant Enterococcus faecium (VREfm) blood isolates carrying Tn1546-type transposons harboring the vanA operon.
    METHODS: All E. faecium blood isolates were collected from eight general hospitals in South Korea during one-year study period. Antimicrobial susceptibility testing and vanA and vanB PCR were performed. Growth rates of E. faecium isolates were determined. The vanA-positive isolates were subjected to whole genome sequencing and conjugation experiments.
    RESULTS: Among 308 E. faecium isolates, 132 (42.9%) were positive for vanA. All Tn1546-type transposons harboring the vanA operon located on the plasmids, but on the chromosome in seven isolates. The plasmids harboring the vanA operon were grouped into four types; two types of circular, nonconjugative plasmids (Type A, n = 50; Type B, n = 46), and two types of putative linear, conjugative plasmids (Type C, n = 16; Type D, n = 5). Growth rates of vanA-positive E. faecium isolates were significantly lower than those of vanA-negative isolates (P < 0.001), and reduction in growth rate under vancomycin pressure was significantly larger in isolates harboring putative linear plasmids than in those harboring circular plasmids (P = 0.020).
    CONCLUSIONS: The possession of vanA operon was costly to bacterial hosts in antimicrobial-free environment, which provide evidence for the importance of reducing vancomycin pressure for prevention of VREfm dissemination. Fitness burden to bacterial hosts was varied by type and size of the vanA operon-harboring plasmid.
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  • 文章类型: Journal Article
    背景万古霉素耐药肠球菌(VRE)在丹麦和欧洲呈上升趋势。利奈唑胺和万古霉素耐药肠球菌(LVRE)令人担忧,因为治疗选择有限。万古霉素可变肠球菌(VVE)带有vanA基因复合物,但在表型上对万古霉素敏感。目的是描述2015年至2022年间丹麦VRE和VVE的克隆变化,并调查VRE和VVE之间的基因型利奈唑胺抗性。方法对2015年至2022年4090例丹麦临床VRE和VVE分离株进行全基因组测序。我们从测序数据中提取万古霉素抗性基因和序列类型(STs),并对屎肠球菌进行核心基因组多位点序列分型(cgMLST)分析。测试所有分离株是否存在编码利奈唑胺抗性的突变或基因。结果99%的VRE和VVE分离株为屎肠球菌。从2015年到2019年,91.1%的VRE和VVE是vanAE.faecium。在2020年,vanB屎肠球菌的数量增加到509个VRE和VVE分离株中的254个。在2015年至2022年之间,七个屎肠球菌簇占主导地位:ST80-CT14vanA,ST117-CT24vanA,ST203-CT859vanA,ST1421-CT1134vanA(VVE集群),ST80-CT1064vanA/vanB,ST117-CT36vanB和ST80-CT2406vanB。我们检测到35种利奈唑胺耐万古霉素的屎肠球菌和8种利奈唑胺耐药的VVEfm。结论从2015年到2022年,VRE和VVE的数量有所增加。VVE簇ST1421-CT1134vanAE.faecium在丹麦的传播令人担忧,尤其是VVE诊断具有挑战性。LVRE的发现,虽然数量很少,我也很担心,因为治疗选择有限。
    BackgroundVancomycin-resistant enterococci (VRE) are increasing in Denmark and Europe. Linezolid and vancomycin-resistant enterococci (LVRE) are of concern, as treatment options are limited. Vancomycin-variable enterococci (VVE) harbour the vanA gene complex but are phenotypically vancomycin-susceptible.AimThe aim was to describe clonal shifts for VRE and VVE in Denmark between 2015 and 2022 and to investigate genotypic linezolid resistance among the VRE and VVE.MethodsFrom 2015 to 2022, 4,090 Danish clinical VRE and VVE isolates were whole genome sequenced. We extracted vancomycin resistance genes and sequence types (STs) from the sequencing data and performed core genome multilocus sequence typing (cgMLST) analysis for Enterococcus faecium. All isolates were tested for the presence of mutations or genes encoding linezolid resistance.ResultsIn total 99% of the VRE and VVE isolates were E. faecium. From 2015 through 2019, 91.1% of the VRE and VVE were vanA E. faecium. During 2020, to the number of vanB E. faecium increased to 254 of 509 VRE and VVE isolates. Between 2015 and 2022, seven E. faecium clusters dominated: ST80-CT14 vanA, ST117-CT24 vanA, ST203-CT859 vanA, ST1421-CT1134 vanA (VVE cluster), ST80-CT1064 vanA/vanB, ST117-CT36 vanB and ST80-CT2406 vanB. We detected 35 linezolid vancomycin-resistant E. faecium and eight linezolid-resistant VVEfm.ConclusionFrom 2015 to 2022, the numbers of VRE and VVE increased. The spread of the VVE cluster ST1421-CT1134 vanA E. faecium in Denmark is a concern, especially since VVE diagnostics are challenging. The finding of LVRE, although in small numbers, ia also a concern, as treatment options are limited.
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  • 文章类型: English Abstract
    世界卫生组织已将抗生素耐药性问题列为世界十大重要健康问题之一。由于通过转座因子在细菌之间传播抗生素抗性,感染性疾病的治疗变得更加困难。耐万古霉素肠球菌(VRE)由于与严重的医院感染和高死亡风险有关,因此具有至关重要的医学和公共卫生重要性。VRE的最重要特征之一是它们具有多种抗生素抗性并且治疗选择减少。因此,需要新的治疗方法。vanA基因构成万古霉素抗性机制的组成部分,并导致对万古霉素的高抗性。在这项研究中,目的通过创建vanA反义RNA(asRNA)来研究万古霉素耐药机制的中和作用。我们的培养物中的vanA阳性VRE50菌株是从临床样本中分离的,通过聚合酶链反应(PCR)扩增vanA基因。通过所用引物中的酶切割位点将扩增的vanA扩增子反向插入pUC19质粒中。将所得质粒与可在革兰氏阳性细菌中复制的pAT392质粒组合,并产生融合质粒。方向被证实的融合质粒,通过电穿孔方法转移至野生菌株VRE50。通过E-Test方法测定转化的VRE(tVRE50)和用作对照的野生型VRE50菌株的最小抑制浓度(MIC)值。野生型VRE50菌株的万古霉素MIC值被确定为1024μg/mL,tVRE50菌株的MIC值为32μg/mL,并确定tVRE50菌株的万古霉素抗性用asRNA(反义RNA)降低。反义RNA技术是中和基因表达的重要方法。这项研究表明,万古霉素抗性基因的中和可能在万古霉素抗性肠球菌菌株中提供较低的MIC值,并导致敏感性增加。这种新方法为通过中和万古霉素耐药机制治疗VRE提供了一种新方法。在这项研究中获得的结果需要得到体内测试的支持。
    The World Health Organization has included the problem of antibiotic resistance among the top 10 important health problems in the world. Treatment of infectious diseases has become more difficult due to the spread of antibiotic resistance between bacteria via transposable elements. Vancomycin-resistant enterococci (VRE) are of critical medical and public health importance due to their association with serious nosocomial infections and high risk of death. One of the most important features of VREs is that they have multiple antibiotic resistance and treatment options are reduced. Therefore, new treatment methods are needed. The vanA gene constitutes the building block of the vancomycin resistance mechanism and causes high resistance to vancomycin. In this study, it was aimed to investigate the neutralization of the vancomycin resistance mechanism by creating vanA antisense RNA (asRNA). The vanA positive VRE50 strain in our culture collection which was isolated from the clinical sample, was used to amplify the vanA gene by polymerase chain reaction (PCR). The amplified vanA amplicon was inserted inversely into the pUC19 plasmid by means of the enzyme cutting sites in the primers used. The resulting plasmid was combined with the pAT392 plasmid which can replicate in gram-positive bacteria and a fusion plasmid was created. The fusion plasmid whose orientation was confirmed, was transferred to the wild strain VRE50 by electroporation method. Minimum inhibitory concentration (MIC) values of transformed VRE (tVRE50) and wild type VRE50 strains used as control were determined by the E-Test method. The vancomycin MIC value of the wild type VRE50 strain was determined as 1024 µg/mL and that of the tVRE50 strain was 32 µg/mL and it was determined that the vancomycin resistance of the tVRE50 strain decreased with asRNA (antisense RNA). Antisense RNA technology is an important method for neutralizing the expression of genes. This study showed that neutralization of the vancomycin resistance gene may provide a lower MIC value in a vancomycin-resistant enterococcus strain and lead to increased susceptibility. This new approach provides a new method for VRE treatment by neutralizing the vancomycin resistance mechanism. The result obtained in this study needs to be supported by in vivo tests.
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  • 文章类型: Journal Article
    在上个世纪,已经分离出了成千上万的大麦(HordeumvulgareL.)突变体,许多被存储在不同国家的基因库中。在目前的工作中,我们开发了一个管道来有效地识别大麦中的因果突变。管道对于位于着丝粒区域的突变也是有效的。通过使用汇集的F2幼苗的全基因组测序进行大量分离分析,我们定位了两个突变,并确定了有限数量的候选基因.我们将管道应用于由xan-j.59(未知突变)和xan-l.82(先前已知)制成的F2映射群体。Xantha-j(xan-j)基因被鉴定为编码叶绿素合酶,催化叶绿素生物合成途径的最后一步:向叶绿素的丙酸侧链添加植醇部分。活性位点的关键氨基酸残基,包括类异戊二烯和叶绿素底物的结合位点,在大麦叶绿素合酶的AlphaFold2生成的结构模型中进行了分析。三个等位基因突变体,表征xan-j.19、xan-j.59和xan-j.64。xan-j.19是一个碱基对缺失,xan-j.59是一个无义突变,xan-j.64在叶绿素合酶中引起S212F取代。我们对xan-j.64的分析和用异色草酮处理生长的大麦,叶绿体类异戊二烯生物合成的抑制剂,表明类异戊二烯底物的结合是质体中叶绿素合酶稳定维持的先决条件。我们进一步建议叶绿素合酶是协调叶绿素和类异戊二烯生物合成的传感器。
    Thousands of barley (Hordeum vulgare L.) mutants have been isolated over the last century, and many are stored in gene banks across various countries. In the present work, we developed a pipeline to efficiently identify causal mutations in barley. The pipeline is also efficient for mutations located in centromeric regions. Through bulked segregant analyses using whole genome sequencing of pooled F2 seedlings, we mapped 2 mutations and identified a limited number of candidate genes. We applied the pipeline on F2 mapping populations made from xan-j.59 (unknown mutation) and xan-l.82 (previously known). The Xantha-j (xan-j) gene was identified as encoding chlorophyll synthase, which catalyzes the last step in the chlorophyll biosynthetic pathway: the addition of a phytol moiety to the propionate side chain of chlorophyllide. Key amino acid residues in the active site, including the binding sites of the isoprenoid and chlorophyllide substrates, were analyzed in an AlphaFold2-generated structural model of the barley chlorophyll synthase. Three allelic mutants, xan-j.19, xan-j.59, and xan-j.64, were characterized. While xan-j.19 is a 1 base pair deletion and xan-j.59 is a nonsense mutation, xan-j.64 causes an S212F substitution in chlorophyll synthase. Our analyses of xan-j.64 and treatment of growing barley with clomazone, an inhibitor of chloroplastic isoprenoid biosynthesis, suggest that binding of the isoprenoid substrate is a prerequisite for the stable maintenance of chlorophyll synthase in the plastid. We further suggest that chlorophyll synthase is a sensor for coordinating chlorophyll and isoprenoid biosynthesis.
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  • 文章类型: Journal Article
    万古霉素经常被用作抵抗多药耐药金黄色葡萄球菌感染的最后一道防线。最近的发现描述了通过将含有vanA操纵子的肠球菌质粒经由涉及称为基因座L2的特定整合位点的同源重组(HR)整合到金黄色葡萄球菌的染色体中来获得万古霉素抗性金黄色葡萄球菌(VRSA)菌株。为了描述获得vanA的所有机制,我们分析了寻找vanA的金黄色葡萄球菌的15,706个基因组,并描述了其遗传环境。我们在从12名患者中分离出的25个金黄色葡萄球菌菌株中发现了完整的vanA操纵子,其中9个与VRE菌株共分离。在转座子Tn1546样元件中发现了VanA,在十七个质粒和八个染色体上。VanA可能是通过肠球菌和葡萄球菌质粒的结合获得的,携带vanA的Tn1546转座和质粒整合到染色体中。我们在不同大陆的2,087个金黄色葡萄球菌菌株基因组(13.3%)中检测到L2,并确定了六个潜在的染色体热点,用于通过HR通过L2整合整个含vanA的肠球菌质粒。这表明最近在纽约患者中描述的情况可以在任何地方再现。监视这种可能性是强制性的,特别是在VRSA和VRE感染或定植的患者中。
    BACKGROUND: Vancomycin is frequently used as a last line of defence against infections due to multidrug-resistant Staphylococcus aureus (S. aureus). A recent finding described the acquisition of vancomycin-resistant S. aureus strains by the integration of an enterococcal plasmid containing the vanA operon into the S. aureus chromosome via homologous recombination involving a specific integration site called locus L2.
    METHODS: To characterise all mechanisms of acquisition of vanA, this study analysed the 15 706 S. aureus genomes to look for vanA and described its genetic environment.
    RESULTS: A complete vanA operon was found in 25 S. aureus strains isolated from 12 patients, including nine co-isolated with vancomycin-resistant Enterococcus strains. VanA was found within transposon Tn1546-like elements on 17 plasmids and eight chromosomes. VanA might be acquired through conjugation of enterococcal and staphylococcal plasmids, transposition of Tn1546 carrying vanA and plasmid integration into the chromosome. Further, L2 was detected in 2087 genomes (13.3%) of S. aureus strains across different continents. Six potential chromosomal hotspots for integration of the entire vanA-containing enterococcal plasmid were identified by homologous recombination via L2.
    CONCLUSIONS: These findings suggest that the recently described scenario in a New York patient could be reproduced anywhere. Surveillance of this possibility is mandatory, especially in patients with vancomycin-resistant Enterococcus infection or colonisation.
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  • 文章类型: Journal Article
    目的:我们分析了四年的实验室数据,以表征该物种并确定斐济肠球菌作为人类病原体的抗菌敏感性。该研究还调查了万古霉素耐药肠球菌(VRE)的分子流行病学。
    方法:这项回顾性研究回顾了斐济中部和东部地区殖民地战争纪念医院(CWMH)和其他医疗机构的细菌学数据。表型,使用当地批准的方案进行抗菌药物敏感性以及vanA和vanBPCR检测.分析中包括每位患者在一年中具有抗菌药物敏感性测试结果的第一批临床分离株。使用WHONET软件和MicrosoftExcel分析数据。
    结果:共报告了1,817株肠球菌分离株,来自CWMH的1415和来自其他医疗机构的402。大多数分离株,75%(n=1362)报告为未分化肠球菌属。,17.8%(n=324)被具体鉴定为粪肠球菌,6.7%(n=122)被鉴定为粪肠球菌。总的来说,10%的肠球菌分离株来自血液培养物。在来自CWMH的分离株中,<15%的屎肠球菌对氨苄西林敏感,万古霉素耐药率为17.2%。总的来说,对874株肠球菌分离株(包括未分化物种)进行了抗万古霉素试验,其中4.8%(n=42)为抗性。所有测试的VRE分离物(n=15)表达vanA基因。
    结论:这项研究证明了VRE的临床重要性,特别是在斐济国家转诊医院的vanAE.faecium。需要增强的表型和分子监测数据,以更好地了解肠球菌流行病学,并帮助指导特定的感染预防和控制措施以及抗生素处方指南。
    OBJECTIVE: We analysed 4 y of laboratory data to characterise the species and determine the antimicrobial susceptibility profiles of enterococci as human pathogens in Fiji. The study also investigated the molecular epidemiology amongst the subset of vancomycin-resistant enterococci (VRE).
    METHODS: This retrospective study reviewed bacteriological data from Colonial War Memorial Hospital (CWMH) and other healthcare facilities in the Central and Eastern divisions of Fiji. Phenotypic, antimicrobial susceptibility and vanA and vanB PCR testing were performed using locally approved protocols. The first clinical isolates per patient with antimicrobial susceptibility testing results in a single year were included in the analysis. Data was analysed using WHONET software and Microsoft Excel.
    RESULTS: A total of 1817 enterococcal isolates were reported, 1415 from CWMH and 402 from other healthcare facilities. The majority of isolates, 75% (n = 1362) were reported as undifferentiated Enterococcus spp., 17.8% (n = 324) were specifically identified as Enterococcus faecalis and 6.7% (n = 122) as E. faecium. Overall, 10% of the enterococci isolates were from blood cultures. Among isolates from CWMH, <15% of E. faecium were susceptible to ampicillin, and 17.2% were vancomycin resistant. Overall, 874 enterococcal isolates (including the undifferentiated species) were tested against vancomycin, of which 4.8% (n = 42) were resistance. All of the VRE isolates tested (n = 15) expressed vanA genes.
    CONCLUSIONS: This study demonstrates the clinical importance of VRE, particularly van A E. faecium in the national referral hospital in Fiji. Enhanced phenotypic and molecular surveillance data are needed to better understand enterococci epidemiology and help guide specific infection prevention and control measures and antibiotic prescribing guidelines.
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  • 文章类型: Journal Article
    由万古霉素耐药肠球菌引起的超越管辖范围的暴发正在全球范围内发生。这项研究的重点是2018年至2021年在广岛两个城市爆发的耐万古霉素肠球菌。日本。该研究涉及使用对103株耐万古霉素肠球菌的全基因组测序进行的遗传和系统发育分析,以确定爆发的来源和传播途径。使用核心基因组多位点序列分型和核心单核苷酸多态性进行系统发育分析;使用BadTrIP推断医院之间的感染途径。疫情是由携带vanA质粒的屎肠球菌序列型(ST)80引起的,它来自在印度分离的菌株A10290。在103个分离株中,93例是在医院之间传播的屎肠球菌ST80。广岛分离株的环状vanA质粒与菌株A10290的vanA质粒相似,并通过接合从屎肠球菌ST80转移到屎肠球菌的其他ST和其他肠球菌。推断的跨医院传播路线表明存在作为枢纽的中心医院,向多家医院传播耐万古霉素肠球菌。我们的研究强调了在主要中心医院进行早期干预以防止感染传播到小型医疗设施的重要性,比如疗养院,医疗资源有限,弱势群体数量众多。
    Outbreaks caused by vancomycin-resistant enterococci that transcend jurisdictional boundaries are occurring worldwide. This study focused on a vancomycin-resistant enterococcus outbreak that occurred between 2018 and 2021 across two cities in Hiroshima, Japan. The study involved genetic and phylogenetic analyses using whole-genome sequencing of 103 isolates of vancomycin-resistant enterococci to identify the source and transmission routes of the outbreak. Phylogenetic analysis was performed using core genome multilocus sequence typing and core single-nucleotide polymorphisms; infection routes between hospitals were inferred using BadTrIP. The outbreak was caused by Enterococcus faecium sequence type (ST) 80 carrying the vanA plasmid, which was derived from strain A10290 isolated in India. Of the 103 isolates, 93 were E. faecium ST80 transmitted across hospitals. The circular vanA plasmid of the Hiroshima isolates was similar to the vanA plasmid of strain A10290 and transferred from E. faecium ST80 to other STs of E. faecium and other Enterococcus species by conjugation. The inferred transmission routes across hospitals suggest the existence of a central hospital serving as a hub, propagating vancomycin-resistant enterococci to multiple hospitals. Our study highlights the importance of early intervention at the key central hospital to prevent the spread of the infection to small medical facilities, such as nursing homes, with limited medical resources and a high number of vulnerable individuals.
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  • 文章类型: Journal Article
    万古霉素可变肠球菌(VVE)细菌在表型上对万古霉素敏感,但他们藏有vanA基因.我们旨在确定临床分离的对万古霉素敏感的屎肠球菌(VSE)分离株中VVE的患病率,以及阐明这些分离株中vanA基因簇的分子特征。值得注意的是,我们调查了VVE的vanA基因簇的患病率和结构。在2021年6月至2022年5月之间,我们收集了连续的,非重复万古霉素敏感屎肠球菌(VSE)样品。进行实时PCR以检测vanA的存在,vanB,还有VanC.将PCR与测序和全基因组测序重叠进行结构分析。通过多位点序列分型确定序列类型(STs)。进行暴露测试以评估分离株获得万古霉素抗性的能力。在测试的282个VSE分离株中,20株(7.1%)为VVE。其中,17个分离株在vanS中的IS1216或IS1542序列中有部分缺失(N=10),vanR(N=5),或vanH(N=2)。所有VVE分离株都属于CC17复合体,包含5个STs,即ST17(40.0%),ST1421(25.0%),ST80(25.0%),ST787(5.0%),和ST981(5.0%)。大多数分离株与三个医院相关克隆(ST17,ST1421和ST80)有关。万古霉素暴露后,20个VVE中有18个获得了万古霉素抗性。考虑到较高的回复率,通过筛查VSE中的vanA来检测VVE对于适当的治疗和感染控制至关重要。
    Vancomycin variable Enterococcus (VVE) bacteria are phenotypically susceptible to vancomycin, but they harbor the vanA gene. We aimed to ascertain the prevalence of VVE among clinically isolated vancomycin-susceptible Enterococcus faecium (VSE) isolates, as well as elucidate the molecular characteristics of the vanA gene cluster within these isolates. Notably, we investigated the prevalence and structure of the vanA gene cluster of VVE. Between June 2021 and May 2022, we collected consecutive, non-duplicated vancomycin-susceptible Enterococcus faecium (VSE) samples. Real-time PCR was performed to detect the presence of vanA, vanB, and vanC. Overlapping PCR with sequencing and whole-genome sequencing were performed for structural analysis. Sequence types (STs) were determined by multilocus sequence typing. Exposure testing was performed to assess the ability of the isolates to acquire vancomycin resistance. Among 282 VSE isolates tested, 20 isolates (7.1%) were VVE. Among them, 17 isolates had partial deletions in the IS1216 or IS1542 sequences in vanS (N=10), vanR (N=5), or vanH (N=2). All VVE isolates belonged to the CC17 complex and comprised five STs, namely ST17 (40.0%), ST1421 (25.0%), ST80 (25.0%), ST787 (5.0%), and ST981 (5.0%). Most isolates were related to three hospital-associated clones (ST17, ST1421, and ST80). After vancomycin exposure, 18 of the 20 VVEs acquired vancomycin resistance. Considering the high reversion rate, detecting VVE by screening VSE for vanA is critical for appropriate treatment and infection control.
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