Department of Clinical Laboratory, Henan Provincial People's Hospital, Zhengzhou, China.
Department of Clinical Laboratory, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
J Clin Microbiol. 2018 Mar 26;56(4). doi: 10.1128/JCM.01932-17. Print 2018 Apr.
The global spread of carbapenem-resistant (CRE) is one of the most severe threats to human health in a clinical setting. The recent emergence of plasmid-mediated colistin resistance gene among CRE strains greatly compromises the use of colistin as a last resort for the treatment of infections caused by CRE. This study aimed to understand the current epidemiological trends and characteristics of CRE from a large hospital in Henan, the most populous province in China. From 2014 to 2016, a total of 7,249 isolates were collected from clinical samples, among which 18.1% (1,311/7,249) were carbapenem resistant. Carbapenem-resistant and carbapenem-resistant were the two most common CRE species, with carbapenemases (KPC) and New Delhi metallo-β-lactamases (NDM), respectively, responsible for the carbapenem resistance of the two species. Notably, >57.0% ( = 589) of the isolates from the intensive care unit were carbapenem resistant. Furthermore, and were found to coexist in one isolate, which exhibited resistance to almost all tested antibiotics. Overall, we observed a significant increase in the prevalence of CRE isolates during the study period and suggest that carbapenems may no longer be considered to be an effective treatment for infections caused by in the studied hospital.
全球范围内碳青霉烯类耐药肠杆菌科细菌（CRE）的传播是临床环境中对人类健康的最严重威胁之一。最近在 CRE 菌株中出现的质粒介导的黏菌素耐药基因，极大地限制了黏菌素作为治疗 CRE 引起的感染的最后手段的使用。本研究旨在了解中国人口最多的省份河南省一家大型医院的 CRE 的当前流行趋势和特征。2014 年至 2016 年，从临床标本中共采集了 7249 株分离株，其中 18.1%（1311/7249）为碳青霉烯类耐药。碳青霉烯类耐药和碳青霉烯类耐药肠杆菌科细菌是两种最常见的 CRE 物种，分别由碳青霉烯酶（KPC）和新德里金属β-内酰胺酶（NDM）导致这两种物种的碳青霉烯类耐药。值得注意的是，57.0%（=589）以上来自重症监护病房的分离株为碳青霉烯类耐药。此外，还发现一种分离株同时存在和，对几乎所有测试的抗生素均表现出耐药性。总体而言，我们观察到研究期间 CRE 分离株的流行率显著增加，并建议在研究医院，碳青霉烯类可能不再被认为是治疗由引起的感染的有效药物。
