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秘鲁利马发现携带 mcr-1 基因的产超广谱β-内酰胺酶肠杆菌科细菌。

Extended-spectrum beta-lactamase-producing enterobacterales carrying the mcr-1 gene in Lima, Peru.

机构信息

Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales - CITBM, Universidad Nacional Mayor de San Marcos, Lima, Perú.

Instituto de Medicina Tropical «Daniel A. Carrión», Departamento Académico de Microbiología Médica, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.

出版信息

Rev Peru Med Exp Salud Publica. 2020 Oct-Dec;37(4):711-715. doi: 10.17843/rpmesp.2020.374.5832. Epub 2021 Feb 3.

Abstract

We analyzed the presence of the mcr-1 gene in 165 extended-spectrum beta-lactamase-producing enterobacterales (ESBL-PE) obtained during 2017, from blood (40), urine (57), lower respiratory secretions (12) and rectal swabs (56) of patients hospitalized in the Instituto Nacional de Enfermedades Neoplásicas (Peru). Antimicrobial identification and susceptibility were determined by the Phoenix M50 automated system; colistin resistance by Colistin Agar-Spot (CAS); mrc-1 detection by colistin pre-diffusion and inhibition with EDTA test (CPD-E) and by polymerase chain reaction (PCR). We found that from the 165 ESBL-PE, 25 were positive for mcr-1 by the CPD-E method and confirmed by PCR. Colistin resistance was found in 20/165 by using the CAS method. Additionally, they showed resistance to fluoroquinolones and gentamicin, while remaining sensitive to amikacin; two isolates presented metallo-carbapenemases. Obtaining data on resistance to last-line antimicrobials (colistin) is crucial to establish measures for its control.

摘要

我们分析了在 2017 年期间从秘鲁国立肿瘤研究所住院患者的血液(40)、尿液(57)、下呼吸道分泌物(12)和直肠拭子(56)中获得的 165 株产超广谱β-内酰胺酶肠杆菌科(ESBL-PE)中 mcr-1 基因的存在。采用 Phoenix M50 自动化系统进行抗菌药物鉴定和药敏试验;采用 Colistin Agar-Spot(CAS)法检测粘菌素耐药性;采用 Colistin Pre-Diffusion and Inhibition with EDTA Test(CPD-E)和聚合酶链反应(PCR)检测 mrc-1。我们发现,在 165 株 ESBL-PE 中,有 25 株通过 CPD-E 方法呈 mcr-1 阳性,并通过 PCR 确认。使用 CAS 法发现 20/165 株对粘菌素耐药。此外,它们对氟喹诺酮类和庆大霉素耐药,但对阿米卡星仍敏感;两种分离株携带金属碳青霉烯酶。获得最后一线抗菌药物(粘菌素)耐药数据对于制定其控制措施至关重要。

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