RESUMEN
Rectal swabs of 104 patients who underwent abdominal surgery were screened for ESBL producers. Sequence types (STs) and resistance genes were identified by whole-genome sequencing of 46 isolates from 17 patients. All but seven isolates were assigned to recognized STs. While 18 ESBL-producing E. coli (EPEC) strains were of unique STs, ESBL-producing K. pneumoniae (EPKP) strains were mainly ST14 or ST15. Eight patients harboured strains of the same ST before and after abdominal surgery. The most prevalent resistant genes in E. coli were blaEC (69.57%), blaCTX-M (65.22%), and blaTEM (36.95%), while blaSHV was present in only K. pneumoniae (41.30%). Overall, genes encoding ß-lactamases of classes A (blaCTX-M, blaTEM, blaZ), C (blaSHV, blaMIR, and blaDHA), and D (blaOXA) were identified, the most prevalent variants being blaCTX-M-15, blaTEM-1B, blaSHV-28, and blaOXA-1. Interestingly, blaCMY-2, the most common pAmpC ß-lactamase genes reported worldwide, and mobile colistin resistance genes, mcr-10-1, were also identified. The presence of blaCMY-2 and mcr-10-1 is concerning as they may constitute a potentially high risk of pan-resistant post-surgical infections. It is imperative that healthcare professionals monitor intra-abdominal surgical site infections rigorously to prevent transmission of faecal ESBL carriage in high-risk patients.
Asunto(s)
beta-Lactamasas , Humanos , beta-Lactamasas/genética , beta-Lactamasas/metabolismo , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Escherichia coli/efectos de los fármacos , Secuenciación Completa del Genoma , Infecciones por Enterobacteriaceae/microbiología , Infecciones por Enterobacteriaceae/epidemiología , Genoma Bacteriano , Antibacterianos/farmacología , Masculino , Femenino , Persona de Mediana Edad , Abdomen/cirugía , Abdomen/microbiología , Anciano , Pruebas de Sensibilidad MicrobianaRESUMEN
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant causative agent of hospital-acquired infections. We characterized MRSA isolated from August 2012 to July 2015 from Thammasat University Hospital. Genotypic characterization of MRSA SCCmec type II and III isolates were scrutinized by whole genome sequencing (WGS). The WGS data revealed that the MRSA SCCmec type II isolates belonged to ST764 previously reported mainly in Japan. All of tested isolates contained ACME Type II', SaPIn2, SaPIn3, seb, interrupted SA1320, and had a virulence gene profile similar to Japan MRSA ST764. Rigorous surveillance of MRSA strains is imperative in Thailand to arrest its potential spread.
Asunto(s)
Staphylococcus aureus Resistente a Meticilina/genética , Adolescente , Anciano , Anciano de 80 o más Años , Infección Hospitalaria/microbiología , Femenino , Humanos , Masculino , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Especificidad de la Especie , Tailandia , Secuenciación Completa del GenomaRESUMEN
We analyzed data of Staphylococcus aureus isolated from patients attending Thammasat University Hospital, Thailand from August 2012 to July 2015. In total, 232/502 (46%) S. aureus isolates were methicillin-resistant S. aureus (MRSA). There was a declining trend of proportion of MRSA infection, but the prevalence of MRSA in the last year of study remained high (38%). All 32 MRSA-infected outpatients had history of exposure to healthcare facilities during the previous two months and thus were not considered as having community-associated MRSA. In addition, all these strains were negative for pvl, suggesting that these strains were hospital-associated MRSA. All MRSA stains were susceptible to linezolid, teicoplanin and vancomycin, but resistance to erythromycin and clindamycin were nearly 100%. Fifty-two percent and 87% of MRSA strains were susceptible to tetracycline and trimethoprim-sulfamethoxazole, respectively. These results emphasize the necessity of long-term surveillance and monitoring of antimicrobial susceptibility pattern of MRSA.