摘要
      在可移动遗传元件（MGE）中存在的抗微生物耐药性基因（ARGs）促进了耐多药细菌的快速发展和传播，这对人类健康来说是一个严重的问题。这是一项One Health研究，旨在调查肺炎克雷伯菌和大肠杆菌的临床和环境分离株中抗生素耐药性决定因素的共存情况。使用各种生物信息学工具来阐明从住院患者（n=20）和环境地点（包括新鲜蔬菜、水果和饮用水）（n=22）获得的42个分离株的菌株ID、耐药性、病毒群、MGE和系统发育。多点序列分型（MLST）显示肺炎克雷伯菌属于10种序列类型（ST），而大肠杆菌属于17种ST。在环境（饮用水、新鲜蔬菜和水果）中以及因术后感染、新生儿败血症和尿路感染住院的患者中检测到携带β-内酰胺、氨基糖苷类耐药性决定因素和MGE的多药耐药分离株。四株肺炎克雷伯菌环境分离株（7E、16EE、1KE和19KE）具有多重耐药性，对不同的β-内酰胺和氨基糖苷类耐药性决定因素呈阳性。在索巴医院儿科和环境中循环的分离株中检测到ISEc9和Tn3转座酶括号中的blaCTX-M-15。这项研究记录了在医院和环境中传播的具有类似抗微生物耐药性决定因素模式的细菌分离株的存在。利益相关者需要迅速做出反应，启动感染预防和控制措施计划，以检测在社区和医院传播的此类克隆。
Abstract
The presence of antimicrobial-resistance genes (ARGs) in mobile genetic elements (MGEs) facilitates the rapid development and dissemination of multidrug-resistant bacteria, which represents a serious problem for human health. This is a One Health study which aims to investigate the co-occurrence of antimicrobial resistance determinants among clinical and environmental isolates of K. pneumoniae and E. coli. Various bioinformatics tools were used to elucidate the bacterial strains’ ID, resistome, virulome, MGEs, and phylogeny for 42 isolates obtained from hospitalized patients (n = 20) and environmental sites (including fresh vegetables, fruits, and drinking water) (n = 22). The multilocus sequence typing (MLST) showed that K. pneumoniae belonged to ten sequence types (STs) while the E. coli belonged to seventeen STs. Multidrug-resistant isolates harbored β-lactam, aminoglycoside resistance determinants, and MGE were detected circulating in the environment (drinking water, fresh vegetables, and fruits) and in patients hospitalized with postoperative infections, neonatal sepsis, and urinary tract infection. Four K. pneumoniae environmental isolates (7E, 16EE, 1KE, and 19KE) were multidrug-resistant and were positive for different beta-lactam and aminoglycoside resistance determinants. blaCTX-M-15 in brackets of ISEc 9 and Tn 3 transposases was detected in isolates circulating in the pediatrics unit of Soba hospital and the environment. This study documented the presence of bacterial isolates harboring a similar pattern of antimicrobial resistance determinants circulating in hospitals and environments. A rapid response is needed from stakeholders to initiate a program for infection prevention and control measures to detect such clones disseminated in the communities and hospitals.

https://www.mdpi.com/1424-8247/15/8/1011