1 Department of Medical Microbiology, Adana City Training and Research Hospital, Adana, Turkey.
2 Department of Infectious Diseases and Clinical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Microb Drug Resist. 2019 May;25(4):551-557. doi: 10.1089/mdr.2018.0231. Epub 2018 Nov 20.
Fifty isolates of isolated from clinical samples between 2012 and 2016 that were found to be resistant to carbapenems were included in this study. Resistance genes were investigated by performing PCR. Plasmid typing was performed using PCR-based replicon typing. The clonal relationships between the strains were investigated using pulsed-field gel electrophoresis (PFGE). OXA-48-type carbapenemase genes were detected in 86% ( = 43/50) of isolates, whereas NDM-type carbapenemase genes were detected in 14% ( = 7/50) of the isolates. bla was detected 60% ( = 30) of the strains, bla in 78% ( = 39), bla in 48% ( = 24), and bla-type β-lactamase in 10% ( = 5). bla and bla were concomitantly distributed in 40% ( = 20) of the strains, bla and bla in 54% ( = 27), bla, bla, and bla in 32% ( = 16) and bla and bla in 10% ( = 5). Strain numbers 66, 69, 76, 77, and 78 coproduced carbapenemases, bla and bla in addition to bla or bla that were described as hybrid strains. IncR-type replicon was found in 50% ( = 25) of 50 isolates with plasmid typing, whereas IncA/C-type replicon was detected in 40% ( = 20) and IncFIIK-type replicon in 18% ( = 9) of the isolates. Outcomes of the transformation experiments showed that the OXA-48 gene was carried to the receiver cell on FII plasmids. No dominant epidemic clone was detected through PFGE. OXA-48 carbapenemase was found to be the most prevalent type of enzyme in our hospital, and the presence of NDM-1-type carbapenemase-carrying strain and an increase in their rate were detected.
本研究纳入了 2012 年至 2016 年间从临床样本中分离出的 50 株对碳青霉烯类药物耐药的 。通过 PCR 检测耐药基因，通过基于 PCR 的复制子分型进行质粒分型，通过脉冲场凝胶电泳（PFGE）检测菌株之间的克隆关系。在 50 株 中，86%（43/50）检测到 OXA-48 型碳青霉烯酶基因，14%（7/50）检测到 NDM-1 型碳青霉烯酶基因。bla 基因在 60%（30/50）的菌株中检出，bla 在 78%（39/50）的菌株中检出，bla 在 48%（24/50）的菌株中检出，bla 型β-内酰胺酶在 10%（5/50）的菌株中检出。bla 和 bla 基因在 40%（20/50）的菌株中同时分布，bla 和 bla 基因在 54%（27/50）的菌株中同时分布，bla、bla 和 bla 基因在 32%（16/50）的菌株中同时分布，bla 和 bla 基因在 10%（5/50）的菌株中同时分布。菌株 66、69、76、77 和 78 共产生碳青霉烯酶，bla 和 bla 基因除了 bla 或 bla 基因外，还被描述为杂交株。在质粒分型的 50 株 中，50%（25/50）发现 IncR 型复制子，40%（20/50）发现 IncA/C 型复制子，18%（9/50）发现 IncFIIK 型复制子。转化实验的结果表明，OXA-48 基因在 FII 质粒上携带到受体细胞。通过 PFGE 未检测到优势流行克隆。在我们医院，OXA-48 碳青霉烯酶是最常见的酶型，检测到携带 NDM-1 型碳青霉烯酶的菌株及其检出率增加。
