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伊朗首次报告产新德里金属β-内酰胺酶-1 的肺炎克雷伯菌。

First report of New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae in Iran.

机构信息

Department of Bacteriology and Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran.

出版信息

Microb Drug Resist. 2013 Feb;19(1):30-6. doi: 10.1089/mdr.2012.0078. Epub 2012 Sep 17.

Abstract

New Delhi metallo-beta-lactamase (NDM-1) is a novel metallo-beta-lactamase (MBL). Sporadic cases of NDM-1 positive strains have been reported from different countries, suggesting a widespread dissemination. The aim of this study was the detection of MBLs in Enterobacteriaceae isolated from patients in Tehran hospitals. After identification tests, the susceptibility to the antibiotics was done by Kirby-Bauer method and broth microdilution. Carbapenem-resistant isolates were tested for carbapenemase production using the modified Hodge test (MHT). Carbapenem-resistant strains screened for bla(KPC) gene and genes encoding MBLs. Twenty-three isolates (6.3%) were resistant to meropenem, eleven isolates (3%) were resistant to ertapenem, and four isolates (1.1%) were resistant to imipenem. MHT was positive in 11 (47.8%) of the carbapenem-resistant isolates. In March 2011, we detected a multiple drug-resistant Klebsiella pneumoniae isolate that was resistant to all tested antibiotics except colistin. PCR confirmed that this isolate contained bla(NDM-1), bla(TEM), bla(SHV), and bla(CTX-M). This is the first report on the detection of MBL NDM-1 in Iran. The rapid spread of NDM-1-positive bacteria proved to be a major challenge for the treatment and control of infectious diseases.

摘要

新德里金属β-内酰胺酶(NDM-1)是一种新型金属β-内酰胺酶(MBL)。来自不同国家的散发性 NDM-1 阳性菌株报告表明其广泛传播。本研究的目的是检测德黑兰医院患者分离的肠杆菌科中产 NDM-1 的菌株。经过鉴定试验,采用 Kirby-Bauer 法和肉汤微量稀释法检测抗生素的敏感性。使用改良 Hodge 试验(MHT)检测耐碳青霉烯类的分离株是否产碳青霉烯酶。对耐碳青霉烯类的菌株进行 bla(KPC)基因和编码 MBLs 的基因检测。23 株(6.3%)对美罗培南耐药,11 株(3%)对厄他培南耐药,4 株(1.1%)对亚胺培南耐药。11 株(47.8%)耐碳青霉烯类的分离株 MHT 阳性。2011 年 3 月,我们检测到一株对所有测试抗生素(除黏菌素外)均耐药的多重耐药肺炎克雷伯菌。PCR 证实该分离株含有 bla(NDM-1)、bla(TEM)、bla(SHV)和 bla(CTX-M)。这是伊朗首次报道检测到 MBL NDM-1。NDM-1 阳性细菌的迅速传播被证明是治疗和控制传染病的重大挑战。

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