In the last years, an increasing number of untreatable infections caused by drug-resistant microbes have impacted the health care system. Worldwide, infections caused by carbapenem-resistant (CR) Gram-negative bacilli have dramatically increased. Among the CR-Gram-negative bacilli, those producing carbapenemases, such as NDM-1, are the main concern. Different Enterobacterales harboring NDM-1 have been reported lately. Providencia stuartii, a member of the Morganellaceae family, is ubiquitous in the environment, but is also known to cause nosocomial infections. Here we describe the genomic analysis of two NDM-1- producing P. stuartii strains recovered from the same patient as well as other carbapenem resistant strains recovered from the same hospital. As a result of the genomic analysis thirteen resistance genes, including three to β-lactams (blaOXA-1, blaTEM-1, blaNDM-1), four to aminoglycosides (aphA6, aac(3)-IId, aac(2')-Ia, aac(6')-Ib-cr5), one to sulfonamides (sul1), two to chloramphenicol (catB3, catA3), one to rifampicin, one to bleomycin (ble), and one to tetracycline (tet(B)) were found. Moreover, a variety of mobile genetic elements, such as insertion sequences, plasmids and phage- related sequences, were found within P. stuartii genomes. The spread of carbapenem-resistant isolates remains a significant clinical and public health concern. Therefore, we considered that the detection of CR isolates is an essential step in addressing this problem.

中文翻译：

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从单个患者身上回收的两个 NDM-1 普罗维登西亚斯图亚特菌株的基因组分析

在过去的几年里，越来越多的由耐药微生物引起的无法治愈的感染影响了医疗保健系统。在世界范围内，由耐碳青霉烯 (CR) 革兰氏阴性杆菌引起的感染急剧增加。在 CR-革兰氏阴性杆菌中，主要关注的是那些产生碳青霉烯酶的细菌，如 NDM-1。最近报道了不同的​​含有 NDM-1 的肠杆菌。斯图亚特普罗维登西亚 (Providencia stuartii) 是摩根氏菌科 (Morganellaceae) 的一员，在环境中无处不在，但也已知会引起院内感染。在这里，我们描述了从同一名患者身上回收的两种产 NDM-1 的斯图亚特假单胞菌菌株以及从同一家医院回收的其他碳青霉烯类耐药菌株的基因组分析。作为基因组分析的结果，十三个抗性基因，包括三个到 β-内酰胺（blaOXA-1、blaTEM-1、blaNDM-1），四个到氨基糖苷类（aphA6、aac(3)-IId、aac(2')-Ia、aac(6')-Ib-cr5 )，发现一种与磺胺类药物 (sul1)、两种氯霉素（catB3、catA3）、一种与利福平、一种与博来霉素 (ble) 以及一种与四环素 (tet(B)) 相关。此外，在 P. stuartii 基因组中发现了多种可移动的遗传元件，例如插入序列、质粒和噬菌体相关序列。耐碳青霉烯分离株的传播仍然是一个重要的临床和公共卫生问题。因此，我们认为 CR 分离株的检测是解决这一问题的必要步骤。一种是博来霉素 (ble)，一种是四环素 (tet(B))。此外，在 P. stuartii 基因组中发现了多种可移动的遗传元件，例如插入序列、质粒和噬菌体相关序列。耐碳青霉烯分离株的传播仍然是一个重要的临床和公共卫生问题。因此，我们认为 CR 分离株的检测是解决这一问题的必要步骤。一种是博来霉素 (ble)，一种是四环素 (tet(B))。此外，在 P. stuartii 基因组中发现了多种可移动的遗传元件，例如插入序列、质粒和噬菌体相关序列。耐碳青霉烯分离株的传播仍然是一个重要的临床和公共卫生问题。因此，我们认为 CR 分离株的检测是解决这一问题的必要步骤。