台州地区708株嗜麦芽寡养单胞菌耐药性变迁研究

目的了解708株嗜麦芽寡养单胞菌构成比及耐药性的变迁,探讨引起耐药性变迁的危险因素、指导临床合理使用抗生素。方法对台州医院2003年至2007年嗜麦芽寡养单胞菌数据进行回顾性研究,统计分析该菌在标本来源构成比、不同科室阳性标本构成比及抗生素耐药率等方面的变迁。结果近5年来,嗜麦芽寡养单胞菌的分离率以痰标本中最高（83.6%）;科室分布2003年至2005年间以脑外科及ICU最高,此后血液肿瘤内科跃居第一;该菌对抗生素的耐药性呈普遍上升趋势。结论注意空气消毒是减少嗜麦芽寡养单胞菌通过呼吸道传播的有效措施;ICU、脑外科及血液肿瘤内科仍需加强护理等措施。避免抗生素的不正当使用及外部设备的长期使用,有利于避免耐药菌的产生,有效控制院感。     

嗜麦芽寡养单胞菌胞外蛋白酶功能研究进展

嗜麦芽寡养单胞菌(Stenotrophomonas maltophilia)是广泛分布于自然界的革兰氏阴性杆菌。作为一种新型、与高死亡率相关的条件致病菌,嗜麦芽寡养单胞菌能够导致人类或其他生物感染多种疾病。近年来,越来越多的研究结果显示来自于细菌的胞外蛋白酶是导致宿主发病的关键蛋白质。因此,探究嗜麦芽寡养单胞菌胞外蛋白酶的组成成分和功能将不仅有助于阐明其致病机制,更为今后以其为靶点进行临床治疗奠定基础。本文试图对嗜麦芽寡养单胞菌胞外蛋白酶的性质、功能及其应用进行归纳总结。     

嗜麦芽寡养单胞菌临床分布特征与耐药分析

目的了解湖州市中心医院嗜麦芽寡养单胞菌临床分布特征与耐药性。方法采用常规方法分离,用VITE-COMPACT2全自动微生物分析仪进行菌种鉴定,用K—B法进行药敏试验。结果分离到嗜麦芽寡养单胞菌810株,复方新诺明耐药菌株48株（分离率5．9％）。标本来源主要来自ICU室,其次呼吸科,大部分来自痰液标本（约占89．2％）,年龄段以中老年人比率最高。嗜麦芽寡养单胞菌对亚胺培南、美罗培南、头孢吡肟、哌拉西彬他坐巴坦、庆大霉素、妥布霉素、阿米卡星高度耐药;头孢他啶、替卡西林／克拉维酸、环丙沙星耐药率为33．7％～58．2％;头孢哌酮／舒巴坦、左氧氟沙星、米诺环素、复方新诺明耐药率低于30．0％。复方新诺明耐药菌株对头孢哌酮／舒巴坦、左氧氟沙星和米诺环素耐药率分别为60．4％、91．7％和2．0％,对其余抗菌药物耐药率达100．0％。复方新诺明耐药菌株与复方新诺明敏感菌株相比,耐药情况更严重,其中对三、四代头孢菌素、喹诺酮类耐药率显著高于复方新诺明敏感菌株（P〈0．01）;对碳青霉烯类、青霉素类、氨基糖苷类抗菌药物耐药率与复方新诺明敏感菌株相比,差异无统计学意义（P〉0．05）。结论嗜麦芽寡养单胞菌呈高度耐药,对头孢哌酮／舒巴坦、左氧氟沙星、米诺环素、复方新诺明尚敏感,但对复方新诺明耐药的嗜麦芽寡养单胞菌耐药现象更严重。应重视嗜麦芽寡养单胞菌引起的院内感染,尽量减少不必要的侵人性操作,加强抗菌药物的合理规范使用。     

亚胺培南临床用药与非发酵菌群分离率和耐药性的关系

目的了解亚胺培南临床用药和非发酵菌群分离率与耐药性变迁的关系,有利于非发酵菌感染的预防与治疗。方法统计分析浙江省人民医院2000～2003年临床分离非发酵菌的菌株分布、与亚胺培南的临床用药的相关性及耐药率。结果4年来非发酵菌的分离以铜绿假单胞菌(30．7％)、乙酸钙-鲍曼不动复合杆菌(19．％)及嗜麦芽糖寡养单胞菌(19．1％)为主．其分离率与亚胺培南用药存在相关性。对各菌属的主要菌种进行耐药性分析,嗜麦芽糖寡养单胞菌、脑膜脓毒性金黄杆菌和洋葱伯克霍尔德菌的耐药率极高,铜绿假单胞菌和乙酸钙-鲍曼不动复合杆菌的耐药率呈现明显升高的趋势。结论非发酵菌的检出率与亚胺培南使用关系密切,耐亚胺培南的菌株迅速升高。临床应合理使用抗生素,并加强对耐药菌株的监控。     

青岛海水浴场多重耐药菌的分布特征研究

为研究海水浴场中的多重耐药菌(multidrug-resistant organism,MDRO)的分布情况、耐药特征及种属,通过抗性筛选平板筛选MDRO,利用K-B纸片法测定其对15种常见抗生素的敏感度,再根据16s rDNA序列同源性比对鉴定MDRO的种属。结果 :从271株可培养的海水细菌中筛选到60(22.1%)株MDRO,60株MDRO对15种药敏纸片的耐药率在31.6%-81.7%之间,其中对磺胺类、氨基糖苷类和磷霉素类抗生素的耐药率较高,对链霉素耐药率最高(81.7%);对链霉素、四环素耐药基因与耐药表型的相关性分析表明,MDRO的耐药性与耐药基因的检出率显著相关;60株MDRO分属于24个菌属,其中寡养单胞菌属占比最大(16%),其次分别为微杆菌属(13%)、短波单胞菌属(8%)、葡萄球菌属(8%)。实验结果揭示了青岛海水浴场的MDRO污染较严重,且多样性丰富,对常见抗生素表现出较强的耐药性。     

一株微囊藻毒素降解辅助菌的分离和鉴定

以从太湖蓝藻中提取的微囊藻毒素作为微囊藻毒素降解菌的筛选物质, 通过稀释平板涂布法从腐烂的蓝藻中富集分离到一菌株, 经形态特征、生理生化特征和16S rDNA 序列分析将该菌株(GenBank 序列登录号为GQ143751)鉴定为藤黄微球菌(Micrococcus luteus); 微囊藻毒素降解实验结果表明该菌株几乎不能降解微囊藻毒素, 但可以明显促进一株微囊藻毒素降解菌微嗜酸寡养单胞菌(Stenotrophomonas acidaminiphila)对微囊藻毒素的降解能力, 将筛选菌株与微嗜酸寡养单胞菌混合培养, 混合菌对微囊藻毒素的降解能力比微嗜酸寡养单胞菌单独培养时提高66.7%。     

2007年至2009年3种非发酵革兰阴性杆菌耐药性分析

目的研究自临床分离的铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽寡养单胞菌等3种非发酵革兰阴性杆菌的耐药性及其变迁,为合理使用抗菌药物提供依据。方法临床标本按常规方法分离培养,用生物梅里埃API分析系统鉴定细菌种类,根据CLSI规定的标准,采用纸片扩散法进行体外药敏测定,WHONET软件进行统计分析。结果 2007年至2009年共分离到铜绿假单胞菌310株、鲍曼不动杆菌280株和嗜麦芽寡养单胞菌86株。其中亚胺培南不敏感的铜绿假单胞菌为32.5%,亚胺培南不敏感的铜绿假单胞菌对其他药物的耐药率也明显高于亚胺培南敏感菌株;鲍曼不动杆菌对大部分抗生素的耐药率都高于60%,对亚胺培南、美罗培南3年总的敏感率为51.6%和48.2%;嗜麦芽寡养单胞菌对米诺环素的敏感率为93.8%。比较3年耐药率的变迁,2009年部分抗菌药物耐药性增长的势头得到遏制。结论非发酵菌是引起院内感染的重要病原菌,对多种抗菌药物都有较高的耐药性,合理使用抗生素,加强医院感染的控制对减少细菌耐药性的产生有非常重要的作用。     

寡养单胞菌属细菌的研究进展

寡养单胞菌属(Stenotrophomonas)囊括了一类革兰氏阴性好氧菌类群,在自然界中的分布呈现生境多样化。目前的16个有效描述种的成员中,既有从临床病人体内分离得到的条件致病菌,也有从植物根际、污水污泥等环境中分离得到的环境有益菌。部分菌株在调节植物生长、辅助生物修复、合成工业酶以及抵抗多重耐药病原体等农业、工业、医药领域,表现出良好的应用研发前景,受到国内外学者的广泛关注。对寡养单胞菌属的建立及分类学特征进行了概述,也从寡养单胞菌属菌株作为病原菌对人类带来的危害,以及作为有益菌在农业、工业、医药等领域的应用前景进行了综述。     

嗜麦芽寡养单胞菌D2株smp基因缺失株的构建及鉴定

为深入研究smp基因的功能,需构建嗜麦芽寡养单胞菌D2株smp基因缺失株。首先,PCR扩增D2株smp基因上游、下游片段作为上下游同源臂,同时扩增获得氯霉素抗性(cat)基因,采用SOE-PCR方法将各片段连接,然后双酶切后克隆入自杀质粒pEX18Tc,构建获得重组自杀质粒pEX18Tc-Δsmp/cat,并转化入大肠埃希菌SM10λpir。通过接合将重组自杀质粒转入嗜麦芽寡养单胞菌D2野生株,经同源重组以cat基因替换野生株的smp基因,链霉素和氯霉素双抗培养基筛选接合子,15%蔗糖选择培养基筛选smp基因缺失株。PCR、酶切和测序验证重组自杀质粒pEX18Tc-Δsmp/cat构建正确,缺失株的分泌蛋白经12%SDS-PAGE证实嗜麦芽寡养单胞菌D2株smp基因缺失株失去表达SMP蛋白的能力。结果显示成功获得smp基因缺失的嗜麦芽寡养单胞菌D2株,为进一步研究其功能和胞外分泌途径奠定基础。     

Occurrence and antagonistic potential of Stenotrophomonas strains isolated from deep-sea invertebrates

Stenotrophomonas maltophilia is known to be of significance as opportunistic pathogen as well as a source of biocontrol and bioremediation activities. S. maltophilia strains have been isolated from rhizospheres, soil, clinical material, aquatic habitats, but little is known about Stenotrophomonas strains recovered from marine environments. During a survey of the biodiversity of Pseudomonas-like bacteria associated with deep-sea invertebrates six Stenotrophomonas strains were isolated from sponge, sea urchin, and ophiura specimens collected from differing Pacific areas, including the Philippine Sea, the Fiji Sea and the Bering Sea. 16S rRNA gene sequence analysis confirmed an assignment of marine isolates to the genus Stenotrophomonas as it placed four strains into the S. maltophilia CIP 60.77^T cluster and two related to the S. rhizophila DSM 14405^T. Together with a number of common characteristics typical of S. maltophilia and S. rhizophila marine isolates exhibited differences in pigmentation, a NaCl tolerance, a range of temperatures, which supported their growth, substrate utilization pattern, and antibiotics resistance. Strains displayed hemolytic and remarkable inhibitory activity against a number of fungal cultures and Gram-positive microorganisms, but very weak or none against Candida albicans. This is the first report on isolation, taxonomic characterization and antimicrobial activity of Stenotrophomonas strains isolated from deep-sea invertebrates.     

Comparative genomics reveals different population structures associated with host and geographic origin in antimicrobial-resistant Salmonella enterica

Genetic variation in a pathogen, including the causative agent of salmonellosis, Salmonella enterica, can occur as a result of eco-evolutionary forces triggered by dissimilarities of ecological niches. Here, we applied comparative genomics to study 90 antimicrobial resistant (AMR) S. enterica isolates from bovine and human hosts in New York and Washington states to understand host- and geographic-associated population structure. Results revealed distinct presence/absence profiles of functional genes and pseudogenes (e.g., virulence genes) associated with bovine and human isolates. Notably, bovine isolates contained significantly more transposase genes but fewer transposase pseudogenes than human isolates, suggesting the occurrence of large-scale transposition in genomes of bovine and human isolates at different times. The high correlation between transposase genes and AMR genes, as well as plasmid replicons, highlights the potential role of horizontally transferred transposons in promoting adaptation to antibiotics. By contrast, a number of potentially geographic-associated single-nucleotide polymorphisms (SNPs), rather than geographic-associated genes, were identified. Interestingly, 38% of these SNPs were in genes annotated as cell surface protein-encoding genes, including some essential for antibiotic resistance and host colonization. Overall, different evolutionary forces and limited recent inter-population transmission appear to shape AMR S. enterica population structure in different hosts and geographic origins.     

Identification of IAA-producing endophytic bacteria from micropropagated Echinacea plants using 16S rRNA sequencing

The presence of latent bacteria is a serious problem in plant tissue cultures. While endophytes are generally beneficial to plants in situ, they may affect culture growth under the modified conditions in vitro. The present study was undertaken to identify and characterize endophytic bacteria associated with the medicinal plant Echinacea in tissue culture. Based on classical microbiological tests and 16S rRNA analyses, it was found that endophytic bacteria associated with aseptically micropropagated Echinacea plantlets are representatives of several genera, Acinetobacter, Bacillus, Pseudomonas, Wautersia (Ralstonia) and Stenotrophomonas. Based on TLC and HPLC analyses, we found that Pseudomonas stutzeri P3 strain produces plant hormone, auxin (indole-3-acetic acid, IAA). Antibiotic resistance was also assessed as a virulence factor. The majority of endophytic bacteria were resistant to the antibiotic kanamycin, but susceptible to chloramphenicol. Recommendations for propagating Echinacea in vitro cultures involve the addition of chloramphenicol, tetracycline, and ampicillin, antibiotics that cause no side effects on these plant species.     

Phenotypic and genotypic profile of clinical and animal multidrug‐resistant Salmonella enterica isolates from Mexico

Aims

The objective of this study was to obtain a phenotypic and genotypic profile of Salmonella enterica including multidrug‐resistant (MDR) isolates from food‐producing animals and clinical isolates, as well as their genetic relatedness in two different States of Mexico (Jalisco and State of Mexico).

Methods and Results

A total of 243 isolates were evaluated in terms of antimicrobial resistance (AMR) and related genes through a disk diffusion method and PCR respectively; we found 16 MDR isolates, all of them harbouring the bla_CMY gene but not qnr genes, these isolates represent less than 10% of the collection. The pulsed‐field gel electrophoresis revealed a higher genotypic similitude within isolates of State of Mexico than Jalisco.

Conclusions

A low percentage of Salmonella isolates were resistant to relevant antibiotics in human health, nevertheless, the AMR and involved genes were similar despite the different serovars and origin of the isolates.

Significance and Impact of the Study

This investigation provided an insight of the current status of AMR of Salmonella isolates in two States of Mexico and pinpoint the genes involved in AMR and their epidemiological relationship, the information could help to determine an adequate therapy in human and veterinary medicine.     

Rapid culture-independent loop-mediated isothermal amplification detection of antimicrobial resistance markers from environmental water samples

Environmental water is considered one of the main vehicles for the transmission of antimicrobial resistance (AMR), posing an increasing threat to humans and animals health. Continuous efforts are being made to eliminate AMR; however, the detection of AMR pathogens from water samples often requires at least one culture step, which is time-consuming and can limit sensitivity. In this study, we employed comparative genomics to identify the prevalence of AMR genes within among: Escherichia coli, Klebsiella, Salmonella enterica and Acinetobacter, using publicly available genomes. The mcr-1, blaKPC (KPC-1 to KPC-4 alleles), blaOXA-48, blaOXA-23 and blaVIM (VIM-1 and VIM-2 alleles) genes are of great medical and veterinary significance, thus were selected as targets for the development of isothermal loop-mediated amplification (LAMP) detection assays. We also developed a rapid and sensitive sample preparation method for an integrated culture-independent LAMP-based detection from water samples. The developed assays successfully detected the five AMR gene markers from pond water within 1 h and were 100% sensitive and specific with a detection limit of 0.0625 μg/mL and 10 cfu/mL for genomic DNA and spiked bacterial cells, respectively. The integrated detection can be easily implemented in resource-limited areas to enhance One Health AMR surveillances and improve diagnostics.     

寡氧单胞菌中CRISPR位点的分析

对寡氧单胞菌基因组中的CRISPR位点进行生物信息学分析。CRISPRdb数据库中公布的和NCBI上下载的共26株寡氧单胞菌的基因组序列,分析其CRISPR位点的分布情况、重复序列、间隔序列以及间隔序列和噬菌体序列数量之间的关系。共发现15个确定的CRISPR结构和132个可疑的CRISPR,不同菌株CRISPR结构中的重复序列具有较强的保守性。间隔序列的靶向基因主要来自细菌的基因组,说明寡氧单胞菌CRISPR的的进化与其他细菌基因有关。此外,间隔序列与前噬菌体数量之间的负相关关系,说明CRISPR能阻止噬菌体的入侵。寡氧单胞菌CRISPR位点的分析为进一步研究耐药性及基因组稳定性奠定了基础。     

Antibiotic resistance of pathogenic <Emphasis Type="Italic">Acinetobacter</Emphasis> species and emerging combination therapy

The increasing antibiotic resistance of Acinetobacter species in both natural and hospital environments has become a serious problem worldwide in recent decades. Because of both intrinsic and acquired antimicrobial resistance (AMR) against last-resort antibiotics such as carbapenems, novel therapeutics are urgently required to treat Acinetobacter-associated infectious diseases. Among the many pathogenic Acinetobacter species, A. baumannii has been reported to be resistant to all classes of antibiotics and contains many AMR genes, such as bla_ADC (Acinetobacter-derived cephalosporinase). The AMR of pathogenic Acinetobacter species is the result of several different mechanisms, including active efflux pumps, mutations in antibiotic targets, antibiotic modification, and low antibiotic membrane permeability. To overcome the limitations of existing drugs, combination theraphy that can increase the activity of antibiotics should be considered in the treatment of Acinetobacter infections. Understanding the molecular mechanisms behind Acinetobacter AMR resistance will provide vital information for drug development and therapeutic strategies using combination treatment. Here, we summarize the classic mechanisms of Acinetobacter AMR, along with newly-discovered genetic AMR factors and currently available antimicrobial adjuvants that can enhance drug efficacy in the treatment of A. baumannii infections.     

Genetic capitalism and stabilizing selection of antimicrobial resistance genotypes in Escherichia coli

Antimicrobial resistance (AMR) in pathogenic strains of bacteria, such as Escherichia coli (E. coli), adversely impacts personal and public health. In this study, we examine competing hypotheses for the evolution of AMR including (i) ‘genetic capitalism’ in which genotypes that confer antibiotic resistance are gained and not often lost in lineages, and (ii) ‘stabilizing selection’ in which genotypes that confer antibiotic resistance are gained and lost often. To test these hypotheses, we assembled a dataset that includes annotations for 409 AMR genotypes and a phylogenetic tree based on genome-wide single nucleotide polymorphisms from 29 255 isolates of E. coli collected over the past 134 years. We used phylogenetic methods to count the times each AMR genotype was gained and lost across the tree and used model-based clustering of the genotypes with respect to their gain and loss rates. We demonstrate that many genotypes cluster to support the hypothesis for genetic capitalism while a few genotypes cluster to support the hypothesis for stabilizing selection. Comparing the sets of genotypes that fall under each of the hypotheses, we found a statistically significant difference in the breakdown of resistance mechanisms through which the AMR genotypes function. The result that many AMR genotypes cluster under genetic capitalism reflects that strong positive selective forces, primarily induced by human industrialization of antibiotics, outweigh the potential fitness costs to the bacterial lineages for carrying the AMR genotypes. We expect genetic capitalism to further drive bacterial lineages to resist antibiotics. We find that antibiotics that function via replacement and efflux tend to behave under stabilizing selection and thus may be valuable in an antibiotic cycling strategy.     

Bacteriophages: A possible solution to combat enteropathogenic Escherichia coli infections in neonatal goats

Due to awareness and benefits of goat rearing in developing economies, goats' significance is increasing. Unfortunately, these ruminants are threatened via multiple bacterial pathogens such as enteropathogenic Escherichia coli (EPEC). In goat kids and lambs, EPEC causes gastrointestinal disease leading to substantial economic losses for farmers and may also pose a threat to public health via the spread of zoonotic diseases. Management of infection is primarily based on antibiotics, but the need for new therapeutic measures as an alternative to antibiotics is becoming vital because of the advent of antimicrobial resistance (AMR). The prevalence of EPEC was established using bfpA gene, uspA gene and Stx1 gene, followed by phylogenetic analysis using Stx1 gene. The lytic activity of the isolated putative coliphages was tested on multi-drug resistant strains of EPEC. It was observed that a PCR based approach is more effective and rapid as compared to phenotypic tests of Escherichia coli virulence. It was also established that the isolated bacteriophages exhibited potent antibacterial efficacy in vitro, with some of the isolates (16%) detected as T4 and T4-like phages based on gp23 gene. Hence, bacteriophages as therapeutic agents may be explored as an alternative to antibiotics in managing public, livestock and environmental health in this era of AMR.     

Distribution and characterization of ampicillin- and tetracycline-resistant <Emphasis Type="Italic">Escherichia coli</Emphasis>from feedlot cattle fed subtherapeutic antimicrobials

Background  

Feedlot cattle in North America are routinely fed subtherapeutic levels of antimicrobials to prevent disease and improve the efficiency of growth. This practice has been shown to promote antimicrobial resistance (AMR) in subpopulations of intestinal microflora including Escherichia coli. To date, studies of AMR in feedlot production settings have rarely employed selective isolation, therefore yielding too few AMR isolates to enable characterization of the emergence and nature of AMR in E. coli as an indicator bacterium. E. coli isolates (n = 531) were recovered from 140 cattle that were housed (10 animals/pen) in 14 pens and received no dietary antimicrobials (control - 5 pens, CON), or were intermittently administered subtherapeutic levels of chlortetracycline (5 pens-T), chlortetracycline + sulfamethazine (4 pens-TS), or virginiamycin (5 pens-V) for two separate periods over a 9-month feeding period. Phenotype and genotype of the isolates were determined by susceptibility testing and pulsed field gel electrophoresis and distribution of characterized isolates among housed cattle reported. It was hypothesized that the feeding of subtherapeutic antibiotics would increase the isolation of distinct genotypes of AMR E. coli from cattle.