背景:铜绿假单胞菌是导致复杂UTI的机会性病原体,并表现出高抗生素耐药性,导致死亡率上升,尤其是在多重耐药菌株的情况下。本研究旨在调查在接受肝移植的终末期肝病患者中鉴定的XDR菌株的抗生素敏感性模式和基因组特征。
方法:在本研究中,登记了30名接受肝移植的患者。收集和处理90个尿液和60个伤口部位的拭子样本用于培养,identification,和抗菌敏感性。通过Sanger测序确认了广泛的耐药菌株EMARA01,然后对其进行全基因组测序以表征基因组模式。使用各种工具和数据库对测序数据进行从头组装处理,包括基因组注释,血清型鉴定,毒力因子基因,和抗菌素抗性基因。使用细菌泛基因组分析(BPGA)软件对随机选择的147个参考菌株和EMAR01测序的菌株进行全基因组分析。
结果:在这些总的检查样本中,在12例患者样本中检测到铜绿假单胞菌引起的医院感染。AST分析表明,铜绿假单胞菌菌株对妥布霉素具有抗性,红霉素,还有庆大霉素,其次是哌拉西林和氧氟沙星,没有菌株对美罗培南和亚胺培南表现出抗性。CARD数据库鉴定出59个与EMAR01菌株基因组相似的AMR基因,并且大部分属于与抗性结瘤细胞分裂(RND)抗生素外排泵有关的家族。五个基因;nalC,nalD,MexR,MexA,还有MexB,对14类抗生素表现出抗药性,而两个AMR;CpxR,而OprM,对15类药物表现出抗药性。Pangenome分析显示,泛基因组仍然是开放的,暗示了获得附属和独特基因的潜力。值得注意的是,使用KEGG数据库鉴定了主要参与氨基酸转运代谢的基因.
结论:这项研究提供了对抗菌药物耐药性的有价值的见解,遗传特征,以及在肝移植患者中引起UTI的铜绿假单胞菌菌株的基因组进化。研究结果强调了理解铜绿假单胞菌AMR机制和遗传多样性对于制定有效的治疗策略和感染控制措施的重要性。
BACKGROUND: Pseudomonas aeruginosa is an opportunistic pathogen responsible for complicated UTIs and exhibits high antibiotic resistance, leading to increased mortality rates, especially in cases of multidrug-resistant strains. This study aimed to investigate the antibiotic susceptibility patterns and genomic characterization of XDR strains identified in end-stage liver disease patients who underwent liver transplants.
METHODS: In this study, a number of 30 individuals who underwent liver transplants were registered. Ninety urine and 60 wound site swab samples were collected and processed for culturing, identification, and antimicrobial sensitivity. Extensively drug-resistant strain EMARA01 was confirmed through Sanger sequencing and was then processed for whole genome sequencing to characterize the genomic pattern. Sequencing data were processed for de novo assembly using various tools and databases, including genome annotation, serotype identification, virulence factor genes, and antimicrobial resistance gene.
Pangenome analysis of randomly selected 147 reference strains and EMAR01 sequenced strain was performed using the Bacterial Pan Genome Analysis (BPGA) software.
RESULTS: Of these total examined samples, nosocomial infection due to P. aeruginosa was detected in twelve patients\' samples. AST analysis showed that P. aeruginosa strains exhibit resistance to tobramycin, erythromycin, and gentamicin, followed by piperacillin and ofloxacin, and no strains exhibit resistance to meropenem and imipenem. The CARD database identified 59 AMR genes similar to the EMAR01 strain genome and mostly belong to the family involved in the resistance-nodulation-cell division (RND) antibiotic efflux pump. Five genes; nalC, nalD, MexR, MexA, and MexB, exhibit resistance to 14 classes of antibiotics, while two AMR; CpxR, and OprM, exhibit resistance to 15 classes of drugs.
Pangenome analysis revealed that the pan-genome remained open, suggesting the potential for acquiring accessory and unique genes. Notably, the genes predominantly involved in amino acid transport metabolism were identified using the KEGG database.
CONCLUSIONS: This study provides valuable insights into the antimicrobial resistance profile, genetic features, and genomic evolution of P. aeruginosa strains causing UTIs in liver transplant patients. The findings emphasize the significance of comprehending AMR mechanisms and genetic diversity in P. aeruginosa for developing effective treatment strategies and infection control measures.