摘要
      在受人类影响的栖息地，特别是在人口稠密的城市，已经检测到抗生素耐药性细菌（ARB）和抗生素耐药性基因（ARGs）。青藏高原远离中国人口稠密的地区，西藏居民有着独特的饮食习惯和肠道微生物。在西藏人群中进行抗生素耐药性监测是罕见的。在这里，我们收集了西藏门诊腹泻患者的粪便样本。从59份样本中获得48株抗生素耐药性肠杆菌科分离株，包括16例患者的19株产超广谱β-内酰胺酶（ESBL）的分离株和22例患者的29株多粘菌素耐药性分离株。在17个大肠杆菌分离株中发现了ESBL或mcr基因，其中约58.8%是耐多药菌株，并发现了10种不相容的质粒类型。blaCTX-M基因是产ESBL大肠杆菌分离株中常见的基因型。4株大肠杆菌分离株含有mcr-1。在从同一样品中获得的不同大肠杆菌分离株中发现了相同的携带mcr-1的质粒，从而证实了mcr-1在细菌之间的水平传播。来自拉萨的大肠杆菌分离株的基因组聚类，来自其他地区的菌株提供了克隆传播的证据。我们的研究结果显示，在患有腹泻的西藏门诊患者中，ARB和ARGs的存在很强，这意味着应该在西藏人群中监测ARB和ARGs。
Abstract
Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) have been detected in human-impacted habitats, especially in densely populated cities. The Qinghai–Tibet Plateau is located far from the heavily populated regions of China, and Tibetan residents have distinct dietary habits and gut microbes. Antibiotic-resistance monitoring in the Tibetan population is rare. Here, we collected stool samples from Tibetan outpatients with diarrhea. From 59 samples, 48 antibiotic-resistant Enterobacteriaceae isolates were obtained, including 19 extended-spectrum beta lactamase (ESBL)-producing isolates from 16 patients and 29 polymyxin-resistant isolates from 22 patients. Either ESBL or mcr genes were found in 17 Escherichia coli isolates, approximately 58.8% of which were multidrug-resistant, and ten incompatible plasmid types were found. The gene blaCTX-M was a common genotype in the ESBL-producing E. coli isolates. Four E. coli isolates contained mcr-1. The same mcr-1-carrying plasmid was found in distinct E. coli isolates obtained from the same sample, thus confirming horizontal transmission of mcr-1 between bacteria. Genomic clustering of E. coli isolates obtained from Lhasa, with strains from other regions providing evidence of clone spreading. Our results reveal a strong presence of ARB and ARGs in Tibetan outpatients with diarrhea, implying that ARB and ARGs should be monitored in the Tibetan population.

https://www.mdpi.com/2079-6382/11/4/508