Hamzan Nurul Izzati, Yean Chan Yean, Rahman Rosliza Abdul, Hasan Habsah, Rahman Zaidah Abdul
Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia;
Emerg Health Threats J. 2015 Mar 10;8:26011. doi: 10.3402/ehtj.v8.26011. eCollection 2015.
Background : Antibiotic resistance among Enterobacteriaceae posts a great challenge to the health care service. The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is attracting significant attention due to its rapid and global dissemination. The infection is associated with significant morbidity and mortality, thus creating challenges for infection control and managing teams to curb the infection. In Southeast Asia, there have been limited reports and subsequent research regarding CRKP infections. Thus, the study was conducted to characterize CRKP that has been isolated in our setting. Methods : A total of 321 K. pneumoniae were included in the study. Each isolate went through an identification process using an automated identification system. Phenotypic characterization was determined using disk diffusion, modified Hodge test, Epsilometer test, and inhibitor combined disk test. Further detection of carbapenemase genes was carried out using polymerase chain reaction and confirmed by gene sequence analysis. Results : All together, 13 isolates (4.05%) were CRKP and the majority of them were resistant to tested antibiotics except colistin and tigercycline. Among seven different carbapenemase genes studied (blaKPC, bla IMP, bla SME, bla NDM, bla IMI, bla VIM, and bla OXA), only two, bla IMP4 (1.87%) and bla NDM1 (2.18%), were detected in our setting. Conclusion : Evidence suggests that the prevalence of CRKP in our setting is low, and knowledge of Carbapenem-resistant Enterobacteriaceae and CRKP has improved and become available among clinicians.
肠杆菌科细菌的抗生素耐药性给医疗服务带来了巨大挑战。耐碳青霉烯类肺炎克雷伯菌（CRKP）的出现因其迅速的全球传播而备受关注。该感染与显著的发病率和死亡率相关，从而给感染控制和管理团队控制感染带来了挑战。在东南亚，关于CRKP感染的报道和后续研究有限。因此，开展本研究以对在我们机构分离出的CRKP进行特征描述。
本研究共纳入321株肺炎克雷伯菌。每株分离菌通过自动化鉴定系统进行鉴定。采用纸片扩散法、改良 Hodge试验、E试验和抑制剂联合纸片试验进行表型特征鉴定。使用聚合酶链反应进一步检测碳青霉烯酶基因，并通过基因序列分析进行确认。
共有13株（4.05%）为CRKP，其中大多数对除黏菌素和替加环素之外的受试抗生素耐药。在研究的7种不同碳青霉烯酶基因（blaKPC、blaIMP、blaSME、blaNDM、blaIMI、blaVIM和blaOXA）中，在我们的研究环境中仅检测到两种，即blaIMP4（1.87%）和blaNDM1（2.18%）。
有证据表明，我们研究环境中CRKP的患病率较低，并且临床医生对耐碳青霉烯类肠杆菌科细菌和CRKP的认识有所提高且已有所了解。
