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中国西南部耐碳青霉烯类情况：NDM-1产生菌感染的耐药性分子分析及危险因素

Carbapenem-Resistant in Southwest China: Molecular Analysis of Resistance and Risk Factors for Infections Caused by NDM-1-Producers.

作者信息

Jia Xiaojiong, Dai Wei, Ma Weijia, Yan Jinrong, He Jianchun, Li Shuang, Li Congya, Yang Shuangshuang, Xu Xiuyu, Sun Shan, Shi Jing, Zhang Liping

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Front Microbiol. 2018 Apr 4;9:658. doi: 10.3389/fmicb.2018.00658. eCollection 2018.

DOI:10.3389/fmicb.2018.00658
PMID:29670607
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5893741/
Abstract

Carbapenem-resistant (CRE) has been considered a serious global threat, but carbapenem resistance remains relatively uncommon in , especially in China. The aim of this study was to characterize carbapenem-resistant (CR-ECL) isolates from 2012 to 2016 in Southwest China. Our study revealed that 20 (15.2%) of the 132 CR-ECL isolates obtained from patients were identified as NDM-1, with most isolates carrying the IncFIIA plasmids. Notably, we initially observed that the strain co-harbored NDM-1 and IMP-8 carbapenemases simultaneously. Analysis of the genetic environment of these two genes has revealed that the highly conserved regions (a---) are associated with the dissemination of NDM-1, while IS26, , and could be involved in the spread of IMP-8. Molecular epidemiology studies showed the nosocomial outbreak caused by NDM-1-producing ST88. Transferring from another hospital and previous carbapenem exposure were identified as independent risk factors for the acquisition of NDM-1-producing These findings emphasize the need for intensive surveillance and precautions to monitor the further spread of NDM-1 in China.

摘要

耐碳青霉烯类肠杆菌科细菌（CRE）已被视为严重的全球威胁，但在中国等地区，碳青霉烯类耐药情况仍相对不常见。本研究旨在对2012年至2016年中国西南地区的耐碳青霉烯类肠杆菌科细菌（CR-ECL）分离株进行特征分析。我们的研究显示，从患者中获得的132株CR-ECL分离株中有20株（15.2%）被鉴定为NDM-1，大多数分离株携带IncFIIA质粒。值得注意的是，我们首次观察到该菌株同时携带NDM-1和IMP-8碳青霉烯酶。对这两个基因的遗传环境分析表明，高度保守区域（a---）与NDM-1的传播有关，而IS26、 和 可能参与IMP-8的传播。分子流行病学研究显示由产NDM-1的ST88引起医院内暴发。从另一家医院转入以及既往碳青霉烯类暴露被确定为获得产NDM-1菌株的独立危险因素。这些发现强调在中国需要加强监测和预防措施以监测NDM-1的进一步传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/5900c89e10ea/fmicb-09-00658-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/4511fc4a80a4/fmicb-09-00658-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/7bf12d2261b4/fmicb-09-00658-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/bc2f8f6fe385/fmicb-09-00658-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/5900c89e10ea/fmicb-09-00658-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/4511fc4a80a4/fmicb-09-00658-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/7bf12d2261b4/fmicb-09-00658-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/bc2f8f6fe385/fmicb-09-00658-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0c2/5893741/5900c89e10ea/fmicb-09-00658-g004.jpg

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