Department of Clinical Microbiology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, 450003, PR China.
Department of Clinical Laboratory, Xiayi Traditional Chinese Medicine Hospital, Shangqiu, Henan, 4764007, PR China.
J Med Microbiol. 2021 Mar;70(3). doi: 10.1099/jmm.0.001325. Epub 2021 Feb 15.
Carbapenem-resistant (CRE) have been responsible for nosocomial outbreaks worldwide and have become endemic in several countries. To better understand the epidemiological trends and characteristics of CRE in the Henan province. We assessed the molecular epidemiological characteristics of 305 CRE strains isolated from patients in 19 secondary or tertiary hospitals in ten areas of the Henan province in China. A total of 305 CRE isolates were subjected to multiple tests, including antimicrobial susceptibility testing, PCR for carbapenemase genes , , , , -. Tigecycline-resistant genes , , , A, , X, M, L were analysed in five tigecycline non-susceptible carbapenem-resistant isolates (TNSCRKP). Additionally, multilocus sequence typing (MLST) was performed for carbapenem-resistant (CRKP). The most common CRE species were (234, 77 %), (36, 12 %) and (13, 4 %). All strains exhibited multi-drug resistance. Overall, 97 % (295/305) and 97 % (297/305) of the isolates were susceptible to polymyxin B and tigecycline, respectively. A total of 89 % (271/305) of the CRE isolates were carbapenemase gene-positive, including 70 % , 13 % , 6 % , and 1 % combined / genes. carbapenemase (KPC) was the predominant carbapenemase in (87 %), whereas NDM and IMP were frequent in (53 %) and (69 %), respectively. Mutations in the , and genes were detected in five TNSCRKP. Moreover, 15 unique sequence types were detected, with ST11 (74 %), ST15 (9 %) and ST2237 (5 %) being dominant among strains. A high proportion of CRE strains were carbapenemase-positive, and five carbapenem-resistant isolates were tigecycline non-susceptible, indicating a need for the ongoing surveillance of CRE and effective measures for the prevention of CRE infections.
碳青霉烯类耐药肠杆菌科细菌（CRE）已在全球范围内导致医院感染，并在多个国家流行。为了更好地了解河南省 CRE 的流行趋势和特征，我们评估了来自中国河南省十个地区 19 家二级或三级医院的 305 株 CRE 分离株的分子流行病学特征。对 305 株 CRE 分离株进行了多种检测，包括抗菌药物敏感性试验、碳青霉烯酶基因 PCR 、Tigecycline 耐药基因、Tigecycline 非敏感碳青霉烯耐药肠杆菌科细菌（TNSCRKP）中 5 株的分析。此外，还对碳青霉烯耐药肠杆菌科细菌（CRKP）进行了多位点序列分型（MLST）。最常见的 CRE 菌种为肺炎克雷伯菌（234 株，77%）、大肠埃希菌（36 株，12%）和阴沟肠杆菌（13 株，4%）。所有菌株均表现出多药耐药性。总体而言，295/305（97%）和 297/305（97%）株对多黏菌素 B 和替加环素敏感。271/305（89%）的 CRE 分离株携带碳青霉烯酶基因，包括 70%blaKPC-2、13%blaCTX-M-15、6%blaNDM-1 和 1%blaIMP-1 基因。KPC 是肠杆菌科细菌中最主要的碳青霉烯酶（87%），而 NDM 和 IMP 则在肺炎克雷伯菌（53%）和大肠埃希菌（69%）中较为常见。在 5 株 TNSCRKP 中检测到、和 基因的突变。此外，在 株中检测到 15 种独特的序列类型，其中 ST11（74%）、ST15（9%）和 ST2237（5%）是主要流行株。碳青霉烯类耐药肠杆菌科细菌分离株中携带碳青霉烯酶的比例较高，5 株碳青霉烯耐药肠杆菌科细菌对替加环素不敏感，这表明需要对 CRE 进行持续监测，并采取有效的措施预防 CRE 感染。
