Sahin Kazım, Tekin Ayse, Ozdas Sule, Akin Demet, Yapislar Hande, Dilek Aziz Ramazan, Sonmez Emine
Department of Microbiology, Medical Faculty, Recep Tayyip Erdogan University, Islampasa mah., 53000, Rize, Turkey.
Department of Infectious Diseases, Cengiz Gökcek Women and Obstetrics Hospital, Osmangazi mah., 27010, Gaziantep, Turkey.
Ann Clin Microbiol Antimicrob. 2015 Oct 6;14:44. doi: 10.1186/s12941-015-0105-1.
Bacterial resistance to antibiotics is increasing worldwide. Antibiotic-resistant strains can lead to serious problems regarding treatment of infection. Carbapenem antibiotics are the final treatment option for infections caused by serious and life-threatening multidrug-resistant gram-negative bacteria. Therefore, an understanding of carbapenem resistance is important for infection control. In the study described herein, the phenotypic and genotypic features of carbapenem-resistant Enterobacteriaceae strains isolated in our hospital were evaluated.
In total, 43 carbapenem-resistant strains were included in this study. Sensitivity to antibiotics was determined using the VITEK(®)2 system. The modified Hodge test (MHT) and metallo-β-lactamase (MBL) antimicrobial gradient test were performed for phenotypic identification. Resistance genes IMP, VIM, KPC, NDM-1, and OXA-48 were amplified by multiplex PCR.
The OXA-48 gene was detected in seven strains, and the NDM-1 gene in one strain. No resistance genes were detected in the remainder of strains. A significant correlation was observed between the MHT test and OXA-48 positivity, and between the MBL antimicrobial gradient test and positivity for resistance genes (p < 0.05).
The finding of one NDM-1-positive isolate in this study indicates that carbapenem resistance is spreading in Turkey. Carbapenem resistance spreads rapidly and causes challenges in treatment, and results in high mortality/morbidity rates. Therefore, is necessary to determine carbapenem resistance in Enterobacteriaceae isolates and to take essential infection control precautions to avoid spread of this resistance.
全球范围内细菌对抗生素的耐药性正在增加。耐药菌株会导致感染治疗方面的严重问题。碳青霉烯类抗生素是治疗由严重且危及生命的多重耐药革兰氏阴性菌引起的感染的最后选择。因此，了解碳青霉烯类耐药性对于感染控制很重要。在本文所述的研究中，对我院分离出的耐碳青霉烯肠杆菌科菌株的表型和基因型特征进行了评估。
本研究共纳入43株耐碳青霉烯类菌株。使用VITEK(®)2系统测定对抗生素的敏感性。进行改良 Hodge 试验（MHT）和金属β-内酰胺酶（MBL）抗菌梯度试验进行表型鉴定。通过多重PCR扩增耐药基因IMP、VIM、KPC、NDM-1和OXA-48。
在7株菌株中检测到OXA-48基因，在1株菌株中检测到NDM-1基因。其余菌株未检测到耐药基因。在MHT试验与OXA-48阳性之间以及MBL抗菌梯度试验与耐药基因阳性之间观察到显著相关性（p < 0.05）。
本研究中发现1株NDM-1阳性分离株表明碳青霉烯类耐药性正在土耳其蔓延。碳青霉烯类耐药性传播迅速，给治疗带来挑战，并导致高死亡率/发病率。因此，有必要确定肠杆菌科分离株中的碳青霉烯类耐药性，并采取必要的感染控制预防措施以避免这种耐药性的传播。
