RESUMO
OBJECTIVE: This study aims to conduct an in-depth genomic analysis of a carbapenem-resistant Proteus mirabilis strain to uncover the distribution and mechanisms of its resistance genes. METHODS: The research primarily utilized whole-genome sequencing to analyze the genome of the Proteus mirabilis strain. Additionally, antibiotic susceptibility tests were conducted to evaluate the strain's sensitivity to various antibiotics, and related case information was collected to analyze the clinical distribution characteristics of the resistant strain. RESULTS: Study on bacterial strain WF3430 from a tetanus and pneumonia patient reveals resistance to multiple antibiotics due to extensive use. Whole-genome sequencing exposes a 4,045,480 bp chromosome carrying 29 antibiotic resistance genes. Two multidrug-resistant (MDR) gene regions, resembling Tn6577 and Tn6589, were identified (MDR Region 1: 64.83 Kb, MDR Region 2: 85.64 Kbp). These regions, consist of integrative and conjugative elements (ICE) structures, highlight the intricate multidrug resistance in clinical settings. CONCLUSION: This study found that a CR-PMI strain exhibits a unique mechanism for acquiring antimicrobial resistance genes, such as blaNDM-1, located on the chromosome instead of plasmids. According to the results, there is increasing complexity in the mechanisms of horizontal transmission of resistance, necessitating a comprehensive understanding and implementation of targeted control measures in both hospital and community settings.
Assuntos
Antibacterianos , Proteínas de Bactérias , Farmacorresistência Bacteriana Múltipla , Testes de Sensibilidade Microbiana , Infecções por Proteus , Proteus mirabilis , Sequenciamento Completo do Genoma , beta-Lactamases , Proteus mirabilis/genética , Proteus mirabilis/efeitos dos fármacos , Proteus mirabilis/enzimologia , Proteus mirabilis/isolamento & purificação , beta-Lactamases/genética , Humanos , Farmacorresistência Bacteriana Múltipla/genética , Antibacterianos/farmacologia , Infecções por Proteus/microbiologia , Proteínas de Bactérias/genética , Cromossomos Bacterianos/genética , Genoma Bacteriano/genética , Carbapenêmicos/farmacologiaRESUMO
ABSTRACT: A 26-year-old woman with pulmonary metastasis of thyroid cancer underwent a total thyroidectomy and cervical lymph node dissection followed by 2 courses of 131I therapy. The posttherapeutic whole-body scan after the second dose of 131I therapy showed diffuse tracer uptake in both lungs. Besides this, there is a local abnormal radiotracer uptake in the left axillary region. SPECT/CT images localized this abnormal radioactivity in a subcutaneous, oval-shaped, approximately 2.2-cm slightly hyperdense lesion, which was pathologically confirmed as an epidermal cyst.
Assuntos
Cisto Epidérmico , Neoplasias da Glândula Tireoide , Feminino , Humanos , Adulto , Radioisótopos do Iodo/uso terapêutico , Cisto Epidérmico/diagnóstico por imagem , Metástase Linfática , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/métodosRESUMO
ABSTRACT: A 75-year-old man with suspected prostate cancer underwent a 99mTc-MDP bone scan to exclude the possibility of bone metastasis. Scans revealed areas of increased tracer uptake in a symmetric distribution on both sides of the pelvis. Further SPECT/CT imaging showed focal 99mTc-MDP accumulation within 2 cystic lesions on both sides of the bladder. Subsequent x-ray cystography showed contrast agent filling within both cystic lesions, which suggested double bladder diverticula. Eventually, these 2 cystic lesions were confirmed by surgery and pathology as double congenital bladder diverticula.