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中国医院分离的铜绿假单胞菌碳青霉烯类耐药的分子流行病学和机制。

Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Chinese hospitals.

机构信息

Respiratory Department, The 1st Affiliated Hospital, Medical School, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Int J Antimicrob Agents. 2010 May;35(5):486-91. doi: 10.1016/j.ijantimicag.2009.12.014. Epub 2010 Feb 24.

DOI:10.1016/j.ijantimicag.2009.12.014
PMID:20185276
Abstract

We investigated the molecular epidemiology and carbapenem resistance mechanisms of 258 non-duplicate carbapenem-resistant clinical isolates of Pseudomonas aeruginosa collected from 2006 to 2007 at 28 hospitals in China. Up to 88% of the carbapenem-resistant isolates were multidrug-resistant. Pulsed-field gel electrophoresis (PFGE) revealed that levels of intrahospital and interhospital dissemination of clones were low. To assess the mechanisms leading to resistance, all 258 carbapenem-resistant isolates were analysed for expression of the chromosomal beta-lactamase (AmpC), the porin important for entry of carbapenems (OprD) and an efflux system (MexAB-OprM) known to extrude some beta-lactams. Carbapenem resistance was driven mainly by mutational inactivation of OprD, accompanied or not by hyperexpression of AmpC or MexAB-OprM. Metallo-beta-lactamase genes were detected in 22 carbapenem-resistant isolates in China, belonging to eight pulsotypes. The bla(OXA-50) gene was detected among all of the carbapenem-resistant isolates, whereas the bla(GES-5) gene was detected in only one carbapenem-resistant isolate.

摘要

我们调查了 258 株非重复耐碳青霉烯类铜绿假单胞菌临床分离株的分子流行病学和碳青霉烯类耐药机制，这些分离株于 2006 年至 2007 年从中国 28 家医院采集。高达 88%的耐碳青霉烯类分离株是多药耐药的。脉冲场凝胶电泳（PFGE）显示，克隆在院内和院间的传播水平较低。为了评估导致耐药的机制，我们对所有 258 株耐碳青霉烯类的分离株进行了分析，以检测染色体β-内酰胺酶（AmpC）、对碳青霉烯类进入起重要作用的孔蛋白（OprD）和已知能排出一些β-内酰胺类抗生素的外排系统（MexAB-OprM）的表达。碳青霉烯类耐药主要是由 OprD 的突变失活引起的，同时伴有或不伴有 AmpC 或 MexAB-OprM 的过度表达。在中国，22 株耐碳青霉烯类的分离株中检测到了金属β-内酰胺酶基因，它们属于 8 个脉冲型。所有耐碳青霉烯类的分离株都检测到了 bla(OXA-50)基因，而只有一株耐碳青霉烯类的分离株检测到了 bla(GES-5)基因。

相似文献

[1]
Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Chinese hospitals.

Int J Antimicrob Agents. 2010-2-24

[2]
Carbapenem resistance mechanisms in Pseudomonas aeruginosa: alterations of porin OprD and efflux proteins do not fully explain resistance patterns observed in clinical isolates.

APMIS. 2005-3

[3]
A highly carbapenem-resistant Pseudomonas aeruginosa isolate with a novel blaVIM-4/blaP1b integron overexpresses two efflux pumps and lacks OprD.

J Antimicrob Chemother. 2007-7

[4]
OprD mutations and inactivation, expression of efflux pumps and AmpC, and metallo-β-lactamases in carbapenem-resistant Pseudomonas aeruginosa isolates from South Korea.

Int J Antimicrob Agents. 2012-5-26

[5]
Mechanisms of carbapenem resistance in non-metallo-beta-lactamase-producing clinical isolates of Pseudomonas aeruginosa from a Tunisian hospital.

Pathol Biol (Paris). 2009

[6]
Molecular epidemiology of carbapenem-resistant Pseudomonas aeruginosa carrying metallo-beta-lactamase genes in Taiwan.

Diagn Microbiol Infect Dis. 2007-10

[7]
[The roles of active efflux system overexpression and outer membrane protein OprD deficiency or loss in carbapenem resistance of Pseudomonas aeruginosa].

Zhonghua Yi Xue Za Zhi. 2006-2-21

[8]
Pseudomonas aeruginosa carbapenem resistance mechanisms in Spain: impact on the activity of imipenem, meropenem and doripenem.

J Antimicrob Chemother. 2011-6-8

[9]
Clonal spread of IMP-1-producing Pseudomonas aeruginosa in two hospitals in Singapore.

J Clin Microbiol. 2004-11

[10]
Outbreak of carbapenem-resistant Pseudomonas aeruginosa producing SPM-1 metallo-{beta}-lactamase in a teaching hospital in southern Brazil.

J Antimicrob Chemother. 2005-12

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[3]
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[4]
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[7]
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Front Cell Infect Microbiol. 2022

[8]
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Antimicrob Agents Chemother. 2022-2-15

[9]
Bloodstream Infections Caused by Carbapenemase-Producing Sequence Type 463, Associated With High Mortality Rates in China: A Retrospective Cohort Study.

Front Cell Infect Microbiol. 2021

[10]
Distribution of Class 1-3 Integrons in Carbapenem-Resistant Isolated from Inpatients in Shiraz, South of Iran.

Ethiop J Health Sci. 2021-7

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