多重耐药寡养单胞菌的基因组学研究进展

寡养单胞菌(Stenotrophomonas)是一类广泛分布于自然环境中的革兰氏阴性非发酵细菌,环境适应能力较强,尤其具备高度耐受抗生素的能力,被认为是耐药基因(antimicrobial resistance,AMR)传播的“物流转运仓库”。临床上寡养单胞菌检出率逐年提高,且耐受抗生素能力及其种类呈现增加态势。本文围绕寡养单胞菌基因组编码的多样性耐药因子,结合基因组学工具开发、抗生素耐药分子机制的研究进展,针对耐药相关因子所涉及的进化/变异和序列编辑技术展开综述。寡养单胞菌的比较基因组学(comparative genomics)研究,可推动耐药菌高效监测与扩散风险防控、解析微生物适应环境关键机制和设计靶向药物。     

多重耐药菌在人类、动物和环境的耐药和传播机制

抗生素等抗菌药物的滥用在全球范围内造成了多重耐药菌的传播。多重耐药菌(Multidrug resistant organisms,MDRO)以及耐药基因(Antibiotic resistance genes,ARGs)可在人类、动物和环境之间进行传播,尤其是ARGs可以通过水平转移的方式在同种属或者不同种属的菌群之间进行传播,使得细菌耐药问题日益严重,耐药机制趋于复杂,疾病治疗更加困难,对人类公众健康造成严重的威胁。因此抗生素等抗菌药物的使用应加以规范。     

食品动物养殖环境中细菌耐药性研究进展

抗生素耐药性被世界卫生组织认为是21世纪人类面临的最大的公共卫生安全问题之一。近年来,抗生素耐药基因作为一种新型污染物而受到广泛关注。养殖场现已成为耐药基因的一个重要储库,耐药菌及耐药基因随着动物排泄物进入环境,从而加速了耐药基因在环境中的传播。畜禽养殖环境中耐药基因和耐药菌可能经食物链、空气等途径传至人类,给人类健康带来巨大威胁。文中结合最新文献,主要介绍了动物养殖场抗菌药物耐药菌和耐药基因的分布特点、耐药基因的持留和传播扩散、研究方法等方面的研究进展,为食品动物养殖环境的抗菌药物耐药性风险评估提供一定支持。     

幽门螺杆菌抗生素耐药机制研究进展

幽门螺杆菌(Helicobacter pylori,H.pylori)感染可引起消化性溃疡、胃粘膜相关淋巴组织淋巴瘤和胃癌。随着抗生素耐药性的问题越来越严重,耐药机制的研究也不断深入。分子检测方法,尤其是核酸检测技术,可高效、快速、准确地检测幽门螺杆菌抗生素耐药基因及突变,对幽门螺杆菌感染的临床治疗发挥重要的指导作用,同时也可对幽门螺杆菌抗生素耐药性进行大规模及时有效监控。本文讨论了关于幽门螺杆菌抗生素耐药机制并着重总结了相关耐药基因及突变。     

斑节对虾(非洲群体)肠道细菌抗生素耐药性及耐药基因分布特征

【目的】解析斑节对虾(Penaeus monodon)(非洲群体)(俗称“金刚虾”,以下同)携带耐药菌及耐药基因现状。【方法】本研究从山东滨州北海新区采集了金刚虾,对其肠道细菌常用抗生素的耐药菌性质及数量、占比及种类进行检测,通过荧光定量PCR技术分析肠道内容物样品中的4类抗生素的4种耐药性基因分布特征。【结果】肠道中可培养细菌总数约1.45×10⁵–2.13×10⁶ CFU/g,有四环素、萘啶酸、氟苯尼考、庆大霉素4种抗生素耐药菌的检出,其中喹诺酮类萘啶酸耐药菌占比最高,达到35.00%,氨基糖苷类庆大霉素占比最少。10种抗生素药敏性质分析表明,肠道可培养细菌对庆大霉素、氟苯尼考等6种抗生素高度敏感,对四环素、卡那霉素中度敏感,对萘啶酸、青霉素、阿莫西林耐药。从分离的耐药菌鉴定结果可以得出,可培养的抗生素耐药菌主要集中在弧菌属,基于属水平的不同抗生素耐药菌统计显示,不同抗生素耐药菌种类存在明显差异,且同一菌属有耐多种抗生素的情况。荧光定量PCR检测分析,4种耐药基因的丰度不同,tet A基因相对拷贝数和四环素耐药菌比例、floR基因和氟苯尼...     

健康猪直肠粪便中沙门菌I类整合子与耐药基因的检测

目的了解安徽省规模化猪场健康猪直肠粪便中沙门菌分离株多重耐药情况及其与I类整合子和耐药基因的携带关系。方法采用标准K-B纸片法对22株沙门菌分离株进行15种抗生素敏感试验;应用PCR技术对沙门菌分离株进行I类整合子及耐药基因检测。结果 22株沙门菌分离株中有20株(90.91%)对2种以上抗生素耐药,属于多重耐药株,羧氨苄青霉素-四环素-卡那霉素-氯霉素-氟苯尼考是主要多重耐药谱;22株沙门菌中有19株(86.4%)携带I类整合子,tetB、aph(3)-IIa和cmlA基因分别检出最高。结论沙门菌多重耐药性与整合子携带之间的关系密切,耐药表型测定结果与耐药基因检测结果基本一致,基因组DNA携带的耐药基因种类多于质粒。     

金黄色葡萄球菌体外抗菌活性分析

抗生素在临床上已广泛应用了数十年 ,在抗感染疾病中发挥了极其重要的作用 ,特别是金黄色葡萄球菌耐药菌株相继出现 ,给临床治疗带来困难。目前已知这种耐药是由位于染色体外的 DNA上的耐药基因所编码 ,并通过接合、转导和转化等方式在细菌间传播 ,其中以接合为最主要。同时在传播过程中 ,这种耐药基因又可不断重新组成新的耐药基因而产生对多种抗生素同时耐药的多重耐药菌株。因此本文对174株金黄色葡萄球菌的耐药机理及抗生素耐药性进行研究 ,对如何减少耐药菌株的产生控制医院内感染的流行 ,指导临床治疗有着一定的意义。1　材料与方法…     

抗生素耐药基因在畜禽粪便-土壤系统中的分布、扩散及检测方法

抗生素耐药基因作为一种新型的环境污染物已引起研究者的高度关注。畜禽养殖业长期将抗生素添加到饲料中,在促进动物生长、预防和治疗动物疾病等方面起了重要作用。这些抗生素大多数不能被动物完全吸收,在动物肠道中诱导出耐抗生素细菌和抗生素耐药基因,并随着粪便排出体外。畜禽粪便作为重要的抗生素、耐抗生素细菌和抗生素耐药基因储存库,通过堆粪、施肥等农业活动进入土壤环境中,可刺激土壤中耐抗生素细菌和抗生素耐药基因的富集。耐药基因借助于基因水平转移等方式在土壤介质中进一步传播扩散,甚至进入植物中随食物链传播,对生态环境和人类健康造成极大的威胁。为了正确评估抗生素耐药基因的生态风险,本文结合国内外相关研究,系统阐述了畜禽粪便-土壤系统中抗生素耐药基因的来源、分布及扩散机制,同时探讨了细菌耐药性的主要研究方法,指出堆肥化处理仍是目前去除抗生素耐药基因的主要手段,并对今后的研究方向进行展望。     

畜禽微生物耐药组研究进展

目前,绝大部分抗生素用于给人类提供肉奶蛋等食品的畜禽,由此产生的抗生素耐药性对全球公众健康造成了巨大威胁。为了降低畜禽生产环节抗生素耐药性向人类的传播,首先需要明确畜禽消化道或产品微生物携带哪些耐药基因。耐药组指的是某个环境微生物群落全部耐药基因的总和,近年来对于畜禽生产过程中耐药组分析成为研究热点之一。本文综述了基于测序技术研究畜禽(猪、鸡、反刍动物)消化道以及乳中微生物耐药组组成及其影响因素的最新进展,并提出了未来研究方向,包括耐药组研究方法的标准化、基于宏转录组的耐药组基因表达研究,以及可移动遗传元件所携带的耐药基因等,旨在为调控畜禽养殖过程中耐药基因提供思路。     

抗生素耐药防控的One Health策略

抗生素耐药作为威胁公共卫生的巨大挑战已经制约了世界经济发展。我国抗生素使用量大,是世界上抗生素滥用最严重的国家之一。文中对人群、食用动物、环境中抗生素耐药产生的原因以及抗生素耐药现状进行综述,针对我国目前抗生素使用与耐药情况,从One Health理念提出了促进抗生素的科学使用、积极探索新型抗生素研发、建立抗生素立体监测网络系统、推广抗生素耐药教育、预防感染等措施,呼吁建立跨学科、跨部门、跨地域的交流与合作,推进我国抗生素耐药防控工作进一步开展,加强环境保护,维护人类与动物的共同健康。     

大熊猫源细菌耐药性研究进展

耐药菌和耐药基因已成为一种新型环境污染物,引发世界公共卫生问题。细菌耐药性尤其是多重耐药菌在人医临床、畜禽养殖以及环境传播等多个方面得到越来越多的关注,而关于大熊猫等野生动物的耐药性研究相对较少。大熊猫(Ailuropoda melanoleuca)是世界公认的珍稀野生动物,其种群数量易受到各种疾病的威胁,尤其是肠道细菌性疾病。随着抗菌药物在疾病预防和控制中的普遍使用,由此带来的耐药性危害日益明显。本文总结了关于大熊猫源细菌耐药的国内外研究报道,对其耐药表型、耐药基因型、耐药机制及水平传播机制等方面内容进行了综述,旨在为大熊猫源细菌耐药性的研究和防控提供依据,为临床科学用药提供理论参考,从而助力大熊猫迁地保护。     

培养法检测海滨浴场细菌多样性及耐药性研究

【目的】耐药基因细菌水平基因转移导致的耐药菌数量增加引发的公共安全问题日益引起人们关注,监测环境中耐药菌变得极为重要。【方法】采集湛江3处滨海浴场的水体、沙滩土样,通过平板稀释涂布和琼脂扩散法进行浴场微生物数量、多样性和抗生素耐药性分析。【结果】3处浴场水体无机氮含量偏高,浴场微生物数量随着客流量逐渐增加,沙滩中微生物数量显著高于水体。浴场细菌分布于3门12科18属,水体中变形菌门（Proteobacteria,49.64%）占优势,沙滩则是厚壁菌门（Firmicutes,54.74%）占优势。浴场细菌对β-内酰胺类耐药率较高,青霉素、万古霉素和头孢曲松耐药率分别达到23.25%、20.53%和17.42%,耐药菌株主要分布于芽孢杆菌属（Bacillus）、弧菌属（Vibrio）、假单胞菌属（Pseudomonas）、链霉菌属（Streptomyces）和肠杆菌属（Enterobacter）,水体中多重耐药细菌数量显著高于沙滩,集中于人流量多的浴场。【结论】滨海浴场环境中细菌耐药菌种类多,需持续监测以评估对当前地区公共卫生的潜在影响。     

Diving into the unknown: identification of antimicrobial resistance hotspots in a tropical urban estuary

Antimicrobial resistance is widely studied and well-characterized from a clinical perspective. However, considerably less information is available regarding resistance in environmental settings, especially in aquatic habitats. This study presents data regarding the occurrence, distribution and the antimicrobial susceptibility profile of bacteria isolated from Guanabara Bay (GB), a heavily polluted tropical urban estuary and an important tourist attraction in Rio de Janeiro, Brazil. Water samples from sites characterized by growing degrees of pollution were analysed by culture-dependent methods, revealing the presence of multidrug-resistant bacteria and clinically relevant indicators of antimicrobial resistance, such as extended-spectrum beta-lactamases. Isolates were identified by mass spectrometry, which indicated the presence of potential human pathogens such as Aeromonas spp. and Vibrio spp. Bacteria harbouring beta-lactam resistance genes were also detected. Although GB is widely used as a recreational and fishing area, there is a substantial knowledge gap regarding the monitoring of antimicrobial resistance and the risk that exposure to these waters poses to public health. Thus, this study reveals new information that calls for better comprehension of antimicrobial resistance in aquatic environments, especially those used for recreational purposes.     

Resistance to tetracycline, macrolide-lincosamide-streptogramin, trimethoprim, and sulfonamide drug classes

The discovery and use of antimicrobial agents in the last 50 yr has been one of medicine’s greatest achievements. These agents have reduced morbidity and mortality of humans and animals and have directly contributed to human’s increased life span. However, bacteria are becoming increasingly resistant to these agents by mutations, which alter existing bacterial proteins, and/or acquisition of new genes, which provide new proteins. The latter are often associated with mobile elements that can be exchanged quickly across bacterial populations and may carry multiple antibiotic genes fo resistance. In some case, virulence factors are also found on these same mobile elements. There is mounting evidence that antimicrobial use in agriculture, both plant and animal, and for environmental purposes does influence the antimicrobial resistant development in bacteria important in humans and in reverse. In this article, we will examine the genes which confer resistance to tetracycline, macrolide-lincosamide-streptogramin (MLS), trimethoprim, and sulfonamide.     

Antibiotic resistance in surface water ecosystems: Presence in the aquatic environment,prevention strategies,and risk assessment

Antibiotic-resistant bacteria (ARB) have gained increased notoriety due to their continued detection in environmental media and consequently their threat to human and animal health. The continuing spread of antibiotic resistance throughout the environment is of growing environmental and public health concern, making it difficult to treat harmful resistant diseases. This paper examines the presence of antibiotics, ARB, and antibiotic-resistant genes (ARGs) in aquatic environments; the effectiveness of current water treatment strategies to remove them; and risk assessment methods available that can be used to evaluate the risk from antibiotic resistance. Antibiotics, ARB, and ARGs have been reported at varying levels in wastewater treatment plants, hospital wastewater, irrigation water, recreational water, and drinking water. There are many different water treatments capable of reducing antibiotic resistance (including chlorination, UV, and ozone); however, no one method can fully eliminate it with much variation in the reported effects. Risk assessment models can be used for interpreting field data into the risk to human health from antibiotic resistance. Currently, there is no gold standard risk assessment method for evaluating antibiotic resistance. Methods in this area need further development to reflect evolving risk assessment methodologies and dynamic data as it emerges.     

Phenotypic and genotypic analysis of bacteria isolated from three municipal wastewater treatment plants on tetracycline‐amended and ciprofloxacin‐amended growth media

Aims: The goal of this study was to determine the antimicrobial susceptibility of bacteria isolated from three municipal wastewater treatment plants. Methods and Results: Numerous bacterial strains were isolated from three municipal wastewater treatment facilities on tetracycline‐ (n = 164) and ciprofloxacin‐amended (n = 65) growth media. These bacteria were then characterized with respect to their resistance to as many as 10 different antimicrobials, the presence of 14 common genes that encode resistance to tetracycline, the presence of integrons and/or the ability to transfer resistance via conjugation. All of the characterized strains exhibited some degree of multiple antimicrobial resistance, with nearly 50% demonstrating resistance to every antimicrobial that was tested. Genes encoding resistance to tetracycline were commonly detected among these strains, although intriguingly the frequency of detection was slightly higher for the bacteria isolated on ciprofloxacin‐amended growth media (62%) compared to the bacteria isolated on tetracycline‐amended growth media (53%). Class 1 integrons were also detected in 100% of the queried tetracycline‐resistant bacteria and almost half of the ciprofloxacin‐resistant strains. Conjugation experiments demonstrated that at least one of the tetracycline‐resistant bacteria was capable of lateral gene transfer. Conclusions: Our results demonstrate that multiple antimicrobial resistance is a common trait among tetracycline‐resistant and ciprofloxacin‐resistant bacteria in municipal wastewater. Significance and Impact of the Study: These organisms are potentially important in the proliferation of antimicrobial resistance because they appear to have acquired multiple genetic determinants that confer resistance and because they have the potential to laterally transfer these genetic determinants to strains of clinical importance.     

整合子系统介导沙门菌耐药性的研究进展

沙门菌(Salmonella spp.)是公共卫生学上具有重要意义的人畜共患病病原菌。人、畜感染沙门菌后会引起伤寒、副伤寒、胃肠炎、败血症和肠外局灶性感染等疾病。抗生素是治疗沙门菌严重感染的有效手段,随着临床和畜牧业中抗生素的大量使用,使得沙门菌的耐药情况日益严重。整合子是普遍存在于细菌中的一种可移动基因元件,可有效捕获外源基因确保其表达,并复合于转座子、质粒等,使多种耐药基因在细菌种内或者种间进行传播。在过去的二十年中,随着新基因盒和复杂整合子的不断出现,导致整合子系统迅速进化。整合子在沙门菌耐药性传播过程中具有非常重要的作用,因此,本文对整合子系统的分子结构、分类、作用机制,以及沙门菌中存在的Ⅰ、Ⅱ、Ⅲ类整合子介导的耐药性及现有检测方法的研究进展进行综述,以期为沙门菌耐药性研究提供参考。     

细菌抗菌肽耐药机制研究进展

细菌对传统抗生素的耐药程度十分严重,寻找克服耐药性的新型抗菌药物已成为当务之急。抗菌肽(antimicrobial peptides,AMPs)是当下较有前景的抗菌药物之一。虽然通常认为,AMPs优先攻击细胞膜的特点使其不会引起广泛的耐药性,但其对特定靶标的识别能力仍为基因突变和细菌耐药性的产生提供了可能。此外,一些细菌还显示出了抵御宿主AMPs的杀伤作用并与宿主细胞共存的能力,相应的细菌防御机制也使其对治疗性AMPs产生抗性,这种交叉抗性近年来也备受关注。这些耐药现象的发现均对AMPs的开发提出了新挑战。本综述就细菌对AMPs耐药的分子机制进行了研究进展的总结,并且对治疗性AMPs与宿主防御肽交叉抗性的相关机制研究进行了归纳,以期寻求新的对抗耐药性的策略。     

Chicken Cathelicidins Display Antimicrobial Activity against Multiresistant Bacteria without Inducing Strong Resistance

The increased prevalence of multidrug-resistant (MDR) bacteria in combination with the relatively limited development of new antibiotics presents a serious threat to public health. In chicken, especially Extended-Spectrum ß-Lactamase (ESBL) carrying Enterobacteriaceae are often asymptomatically present but can infect humans. Due to their broad range antimicrobial activity cathelicidins and other host defence peptides, are considered to be an attractive alternative to conventional antibiotics. In this study, the antimicrobial activity of three chicken cathelicidins against a broad array of multidrug resistant bacteria was determined. All three peptides showed high antibacterial activity independent of the presence of MDR characteristics. Induction experiments using S. aureus and K. pneumoniae showed that although an increase in resistance was initially observed, susceptibility towards chicken cathelicidins remained high and no major resistance was developed. The combined results underline the potential of chicken cathelicidins as a new alternative to antibiotics.     

Antibiotic resistance and extended spectrum beta-lactamases: Types,epidemiology and treatment

Antibiotic resistance is a problem of deep scientific concern both in hospital and community settings. Rapid detection in clinical laboratories is essential for the judicious recognition of antimicrobial resistant organisms. Production of extended-spectrum β-lactamases (ESBLs) is a significant resistance-mechanism that impedes the antimicrobial treatment of infections caused by Enterobacteriaceae and is a serious threat to the currently available antibiotic armory. ESBLs are classified into several groups according to their amino acid sequence homology. Proper infection control practices and barriers are essential to prevent spread and outbreaks of ESBL producing bacteria. As bacteria have developed different strategies to counter the effects of antibiotics, the identification of the resistance mechanism may help in the discovery and design of new antimicrobial agents. The carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by ESBL-producing Enterobacteriaceae, although comparative clinical trials are scarce. Hence, more expeditious diagnostic testing of ESBL-producing bacteria and the feasible modification of guidelines for community-onset bacteremia associated with different infections are prescribed.