Chen Sheng, Feng Wei, Chen Jianhong, Liao Wei, He Nianhai, Wang Qian, Sun Fengjun, Xia Peiyuan
Department of Pharmacy, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
Ann Clin Microbiol Antimicrob. 2014 Aug 12;13:42. doi: 10.1186/s12941-014-0042-4.
The rapid emergence and dissemination of carbapenem resistance in Enterobacteriaceae complicates the treatment of infections caused by these organisms.
We collected clinical isolates with meropenem inhibition zones of ≤ 22 mm from January 1, 2009, through December 31, 2010. We attempted to amplify the NDM-1 gene from these isolates and conducted the modified Hodge test (MHT). The minimal inhibitory concentration (MIC) of the MHT-positive strains was determined by the agar disk dilution method. The carbapenemase-encoding resistance genes of these strains were examined using polymerase chain reaction (PCR) analysis and a sequencing strategy to characterize these enzymes. The clonal relationship among isolates was analyzed by pulsed-field gel electrophoresis (PFGE).
Among the 158 Enterobacteriaceae isolates that were collected, there were no NDM-1-positive strains and 26 MHT-positive strains. Among the latter, 18 strains were IMP-4-positive, and 1 was KPC-2-positive. In addition, 15 of the IMP-4-positive Klebsiella pneumoniae strains belonged to 4 PFGE genotypes, with 8 strains having the same genotype.
These results suggest that nosocomial infections are one of the main reasons for the spread of these resistant strains.
肠杆菌科细菌中碳青霉烯耐药性的迅速出现和传播使这些微生物引起的感染治疗复杂化。
我们收集了2009年1月1日至2010年12月31日美罗培南抑菌圈直径≤22毫米的临床分离株。我们试图从这些分离株中扩增NDM-1基因并进行改良 Hodge试验（MHT）。通过琼脂纸片扩散法测定MHT阳性菌株的最低抑菌浓度（MIC）。使用聚合酶链反应（PCR）分析和测序策略检测这些菌株的碳青霉烯酶编码耐药基因，以鉴定这些酶。通过脉冲场凝胶电泳（PFGE）分析分离株之间的克隆关系。
在收集的158株肠杆菌科细菌分离株中，没有NDM-1阳性菌株，有26株MHT阳性菌株。在后者中，18株为IMP-4阳性，1株为KPC-2阳性。此外，15株IMP-4阳性肺炎克雷伯菌菌株属于4种PFGE基因型，其中8株具有相同的基因型。
这些结果表明医院感染是这些耐药菌株传播的主要原因之一。
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