AI Article Synopsis

  • The study investigates the epidemiology, antimicrobial resistance, and virulence factors of A. caviae, linked to extra-intestinal infections, over a three-year period, highlighting its role as an opportunistic pathogen, particularly in immunocompromised patients with underlying health issues.
  • Out of 47 clinical isolates examined, 19 showed multidrug resistance, while low resistance rates were found for certain antibiotics like piperacillin-tazobactam and levofloxacin, indicating potential treatment options.
  • Most isolates possessed virulence genes, suggesting a significant threat for infection cases, yet the overall mortality rate from these extra-intestinal infections remained low, and the analysis suggests a risk of hospital

Article Abstract

Objective: () is one of the major etiological agents in human intestinal infections reported to be associated with a broad spectrum of extra-intestinal infections with increasing incidence over recent years. Although previous studies have established its significance as a causative agent of both bloodstream and gastrointestinal infections, the characteristics of A. caviae that cause extra-intestinal infections remain unilluminated.In this single-center retrospective study, we investigated epidemiological characteristics, antimicrobial resistance genes and phenotypes, virulence genes, and phyloevolution of 47 clinical isolated from patients with extra-intestinal infections from 2017 to 2020.

Methods: strains were identified by biochemical tests and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF/MS), ultimately confirmed to species level by whole-genome sequencing (WGS). Antimicrobial resistance and virulence genes were identified using the Comprehensive Antibiotic Resistance Database (CARD) and the virulence factor database (VFDB), respectively. Phylogenetic analysis of 47 clinical strains was performed by combining with 521 strains from NCBI database.

Results: was an opportunistic pathogen in immunocompromised patients, especially those with underlying hepatobiliary diseases and malignancies. 19 out of 47 isolates were identified as multidrug resistance (MDR) strains. Piperacillin-tazobactam, levofloxacin, gentamicin, amikacin with a resistance rate of less than 10% remained as options to treat extra-intestinal infections. 24 out of 47 isolates exhibited non-susceptibility to cephalosporins and cephamycins, all of which carried β-lactamase gene, including , , , , and . Most stains (98%, 46/47) carried at least one of the virulence genes, but extra-intestinal infections had a low mortality rate. Phylogenetic analysis indicated the risk of nosocomial transmission but revealed no outbreak. However, the emergence of MDR and β-lactamase resistance genes in extra-intestinal isolates of is becoming an increasing risk to public health and requires attention.

Conclusions: This study strengthen our understanding of isolated from extra-intestinal infections. It may contribute to the management of extra-intestinal infections as well as the prevention and control of drug resistance.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9999030PMC
http://dx.doi.org/10.3389/fcimb.2023.1084352DOI Listing

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