Introduction. Multidrug-resistant (MDR) Gram-negative bacilli including carbapenem-resistant Gram-negative Enterobacteriaceae (CRE) threaten global health. Little is known, however, about the distribution of antimicrobial resistance genes in MDR isolated from patients in Vietnamese hospitals. In this study, we collected MDR Escherichia coli, defined as E. coli resistance against all fluoroquinolones, aminoglycosides, and carbapenems. Aim. This study was designed to clarify the molecular epidemiology of Escherichia coli isolates resistant to carbapenems, fluoroquinolones, and aminoglycosides isolated from patients admitted to one of the largest hospitals in Vietnam in 2014–2019 based on both whole-genome sequencing (WGS) and phenotypic data. Methodology. Sixty-seven Vietnamese isolates screened by drug resistance by the disk test were subjected to WGS, and their sequences were analyzed to determine their multilocus sequence type (MLST), O-types, H-types, distribution of drug resistance genes, plasmid types, pathogenicity islands (PIs), virulence factor distribution, and phylogenetic evolution using the WGS data. Results. Among the STs detected, ST410 was relatively dominant. Dominant O-types and H-types were O102 and H9 and showed some links, such as those between O102 and H8. The most dominant plasmid type and carbapenemase type were 4 and NDM-5, respectively. MLST, O-types, H-types, plasmid types, and types of carbapenemases were very heterogeneous among the isolates, with no clear correlation between them. Dominant plasmid type carrying drug resistance gene was IncQ1_1. The percentage of isolates positive for drug resistance genes, such as anti-beta-lactams and aminoglycosides, was relatively high because the isolates screened were resistant to carbapenems, fluoroquinolones, and aminoglycosides. Conclusions. MDR E. coli isolates isolated at a high-volume Vietnamese hospital were very heterogeneous, suggesting that they were acquired from different sources, including nosocomial infection, animals, and water. Eradication of MDR E. coli from hospitals and other clinical environments is very challenging because a single measure may be ineffective.

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2014-2019 年从越南最大的医院之一分离出的对碳青霉烯类、氟喹诺酮类和氨基糖苷类耐药的大肠杆菌的分子流行病学

介绍。多重耐药（MDR）革兰氏阴性杆菌，包括耐碳青霉烯类革兰氏阴性肠杆菌（CRE），威胁着全球健康。然而，人们对越南医院患者分离出的耐多药耐药基因的分布知之甚少。在这项研究中，我们收集了耐多药大肠杆菌，定义为对所有氟喹诺酮类、氨基糖苷类和碳青霉烯类药物具有耐药性的大肠杆菌。目的。本研究旨在根据全基因组测序 (WGS) 和表型数据，阐明从 2014 年至 2019 年越南最大医院之一收治的患者中分离出的对碳青霉烯类、氟喹诺酮类和氨基糖苷类耐药的大肠杆菌分离株的分子流行病学。方法。对通过纸片试验筛选出的67株越南分离株进行全基因组测序（WGS），分析其序列，确定其多位点序列类型（MLST）、O型、H型、耐药基因分布、质粒类型、使用 WGS 数据分析致病性岛 (PI)、毒力因子分布和系统发育进化。结果。在检测到的ST中，ST410相对占优势。主要的 O 型和 H 型是 O102 和 H9，并显示出一些联系，例如 O102 和 H8 之间的联系。最主要的质粒类型和碳青霉烯酶类型分别是4和NDM-5。分离株之间的 MLST、O 型、H 型、质粒类型和碳青霉烯酶类型非常异质，它们之间没有明显的相关性。携带耐药基因的优势质粒类型为IncQ1_1。由于筛选的菌株对碳青霉烯类、氟喹诺酮类和氨基糖苷类耐药，因此抗β-内酰胺类和氨基糖苷类耐药基因阳性的分离株比例相对较高。结论。在越南一家大量医院分离出的耐多药大肠杆菌分离株非常异质，表明它们是从不同来源获得的，包括医院感染、动物和水。从医院和其他临床环境中根除耐多药大肠杆菌非常具有挑战性，因为单一措施可能无效。