Епидемиологично типизиране на нозокомиални карбапенем-резистентни изолати Acinetobacter baumannii чрез молекулярногенетични методи и техники, базирани на целогеномно секвениране
Ключови думи :
карбапенем-резистентни изолати Acinetobacter baumannii, мултиплекс PCR за идентификация на секвенционни групи и клонове, целогеномно секвениране, типизиране чрез мултилокусно секвениране, KL типизиране, OCL типизиране, международен клон 2, глобален високорисков клон ST2Абстракт
Целта на настоящото проучване е извършване на епидемиологично типизиране на нозокомиални карбапенем-резистентни изолати Acinetobacter baumannii (CRAB) от четири университетски болници в България чрез молекулярногенетични методи и техники, базирани на целогеномно секвениране (WGS). Бяха изследвани общо 80 CRAB (2014–2024 г.), предварително идентифицирани с автоматизирани системи. Методологията включваше: определяне на антимикробна чувствителност, полимеразна верижна реакция (PCR) за откриване на гени за карбапенемази, WGS, мултиплекс PCR за идентификация на секвенционни групи и международни клонове (ICs), мултилокусно секвенционно типизиране (MLST), KL (локус за капсулен полизахарид) и OCL (локус за външномембранен коров липоолигозахарид) типизиране. Проучените CRAB бяха категоризирани като изолати с множествена (8.8%), екстензивна (52.5%) и екстензивна + трудна за лечение антимикробна резистентност (38.8%). Бяха установени придобити карбапенемази от клас D със следната честота на разпространение: 92.5% OXA-23-like, 3.8% OXA-24/40-like и 3.8% OXA-23-like + OXA-24/40-like. WGS доказа OXA-23 и OXA-72 (група OXA-24/40-like). Резултатите от мултиплекс PCR показаха превес на IC2 (76.7%), следван от секвенционна група G5 (15%). При WGS-базиран MLST анализ на 20 CRAB изолата, деветнадесет принадлежаха към секвенционен тип (ST) 2 (IC2) и един към ST636 (IC2). ST2 се беше асоциирал с OCL1 и няколко KL типа (KL9, KL77, KL2 и KL3), докато ST636, съответно с OCL2 и KL40. В заключение, проведеното епидемиологично типизиране на CRAB изолати разкрива явно доминиране на IC2 (общо 82.5%, определени чрез двете групи методи) и глобалния високорисков клон ST2 (95%) в мониторираните болници за проследения 10-годишен период. KL типизирането е ценен инструмент, притежаващ висока дискриминационна способност за разграничаване на нозокомиални изолати A. baumannii по хронология и място на изолиране.
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