Pacheco Tatiana, Bustos-Cruz Rosa Helena, Abril Deisy, Arias Sara, Uribe Lina, Rincón Jenny, García Julio-Cesar, Escobar-Perez Javier
Grupo Evidencia Terapéutica, Clinical Pharmacology, Universidad de la Sabana, Chía 140013, Colombia.
Laboratorio de Genética Molecular Bacteriana, Universidad El Bosque, Bogotá 111321, Colombia.
Antibiotics (Basel). 2019 Jul 20;8(3):98. doi: 10.3390/antibiotics8030098.
, a bacterium commonly isolated from hospital settings, exhibits intrinsic resistance to a number of antibiotics and can acquire resistance during antibiotic therapy. Resistance towards carbapenems is increasing due to its overuse in the treatment of infections caused by extended-spectrum β-lactamase (ESBL) producing organisms. Nonetheless, carbapenems are essential for the treatment of high-risk infections and are one of the remaining weapons in the fight against "extreme drug resistance" of Gram-negative/positive bacilli. Herein, we describe a case report of infections caused by strains that carry and carbapenemase genes simultaneously, identified in five patients who were admitted to a high complexity health institution in Colombia. Molecular characterization included PCR screening for , , , , and carbapenemase and other resistance genes as well as analysis of the genetic relationships by genome macro-restriction and Pulsed-Field Gel Electrophoresis (PFGE) separation. In conclusion, these infections represent a major challenge to public health due to the risk of the infection spreading compounded by the fact that limited treatment options are available, thereby increasing the risk of increased morbidity and mortality.
一种通常从医院环境中分离出的细菌，对多种抗生素表现出固有抗性，并且在抗生素治疗期间可获得抗性。由于碳青霉烯类药物在治疗由产超广谱β-内酰胺酶（ESBL）的生物体引起的感染中过度使用，对其的耐药性正在增加。尽管如此，碳青霉烯类药物对于治疗高危感染至关重要，并且是对抗革兰氏阴性/阳性杆菌“极端耐药性”的剩余武器之一。在此，我们描述了在哥伦比亚一家高复杂性医疗机构收治的五名患者中鉴定出的同时携带 和 碳青霉烯酶基因的 菌株引起感染的病例报告。分子特征包括对 、 、 、 、 和 碳青霉烯酶及其他抗性基因进行PCR筛查，以及通过基因组宏观限制性分析和脉冲场凝胶电泳（PFGE）分离分析遗传关系。总之，由于感染传播的风险，加上可用治疗选择有限，这些感染对公共卫生构成重大挑战，从而增加了发病率和死亡率上升的风险。
