Department of Laboratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, 2 Fuxue lane, Wenzhou 325000, China.
BMC Microbiol. 2013 Dec 5;13:282. doi: 10.1186/1471-2180-13-282.
Emergence of multidrug resistance in Enterobacteriaceae limits the selection of antimicrobials for treatment of infectious diseases. Identification of NDM-1 makes more difficulty in treating multidrug-resistant Enterobacteriaceae infections. Carbapenem-resistant Escherichia coli clinical isolates from a tertiary hospital in Wenzhou, east China, were investigated for NDM-1 production.
The two tested isolates were negative for modified Hodge test, but positive for a double-disc synergy test used for detecting metallo-β-lactamase production. E. coli WZ33 and WZ51 exhibited discrepant-level resistance to most clinically frequent used antimicrobials, but still susceptible to trimethoprim/sulfamethoxazole, amikacin, fosfomycin, tigecycline and polymyxin B. E. coli WZ33 and WZ51 were positive for bla(NDM-1) determined by PCR and DNA sequencing. Other than bla(NDM-1), E. coli WZ33 also harbored bla(CTX-M-14) and bla(CMY-42), while E. coli WZ51 simultaneously harbored blaSHV-12,bla(CTX-M-14) and bla(CMY-42). Carbapenem resistance for E. coli WZ51 and WZ33 could not be transferred to E. coli recipients through conjugation, but could be transferred to E. coli recipients by chemical transformation. The EcoR1-digested DNA pattern of plasmids from the transformant of E. coli WZ51 was different from that of E. coli WZ51. MLST showed that E. coli WZ33 and WZ51 belonged to an animal-associated clone (ST167).
The present study is the first report of bla(NDM-1) carriage in E. coli ST167 isolates and coexistence of bla(NDM-1) and bla(CMY-42) in same isolate. Systemic surveillance should focus on the dissemination of bla(NDM-1) among Enterobacteriaceae, especially E. coli ST167 clone associated with animal infection.
肠杆菌科出现多药耐药性,限制了抗感染治疗中抗菌药物的选择。NDM-1 的出现使治疗多重耐药肠杆菌科感染更加困难。本研究调查了中国东部温州市一家三级医院的耐碳青霉烯大肠埃希菌临床分离株是否产 NDM-1。
两株受试分离株改良 Hodge 试验阴性,但双纸片协同试验阳性,可用于检测金属β-内酰胺酶的产生。WZ33 和 WZ51 型大肠埃希菌对大多数临床常用抗菌药物表现出不一致的耐药水平,但仍对复方磺胺甲噁唑、阿米卡星、磷霉素、替加环素和黏菌素 B 敏感。PCR 和 DNA 测序结果均显示两株菌 bla(NDM-1)阳性。除 bla(NDM-1)外,WZ33 型大肠埃希菌还携带 bla(CTX-M-14)和 bla(CMY-42),而 WZ51 型大肠埃希菌同时携带 blaSHV-12、bla(CTX-M-14)和 bla(CMY-42)。WZ51 和 WZ33 型大肠埃希菌的碳青霉烯耐药性不能通过接合转移到大肠埃希菌受体,但可以通过化学转化转移到大肠埃希菌受体。WZ51 型大肠埃希菌转化子的 EcoR1 酶切 DNA 图谱与 WZ51 型大肠埃希菌不同。MLST 显示,WZ33 和 WZ51 型大肠埃希菌属于动物相关克隆(ST167)。
本研究首次报道了 ST167 型大肠埃希菌携带 bla(NDM-1),以及同一分离株同时携带 bla(NDM-1)和 bla(CMY-42)。系统监测应重点关注肠杆菌科,特别是与动物感染相关的 ST167 克隆中 bla(NDM-1)的传播。