艰难拟梭菌的分子流行病学及耐药特征

Molecular epidemiology of Clostridioides difficile and its resistance

艰难拟梭菌能引起医院获得性抗菌药物相关性腹泻,是抗菌药物耐药紧急威胁之一。全球各地区流行菌株有所差异,欧美主要流行高毒力菌株RT027,中国最常见的是ST3、ST37和ST54菌株。全球不同区域艰难拟梭菌对抗菌药物的敏感性不同,大部分对甲硝唑和万古霉素仍然敏感,对喹诺酮类、克林霉素耐药率高,多重耐药菌常见。欧美常见的耐药菌株类型为RT027,中国为ST3、ST35、ST37和ST54型别。抗菌药物的管理和医院感染的控制是遏制艰难拟梭菌耐药、暴发流行的主要措施。

Clostridioides difficile can cause hospital-acquired antibiotic-associated diarrhea,which is one of the urgent threat of antimicrobial resistance.The prevalent strains of Clostridioides difficile vary across different regions globally.In Europe and America,the high-virulent RT027 is predominant,while in China,the most common strains are ST3,ST37,and ST54.The susceptibility of Clostridioides difficile to antimicrobial drugs varies in different regions worldwide.Most strains remain sensitive to metronidazole and vancomycin,but have high resistance to quinolones and clindamycin,and multidrug-resistant strains are common.The resistant strains commonly found in Europe and America are of type RT027,whereas in China,they are of type ST3,ST35,ST37,and ST54.Effective management of antimicrobial drugs and control of hospital infections are key measures for curb the resistance and outbreak of Clostridioides difficile.