安徽省某三级医院耐黏菌素和碳青霉烯类肠杆菌科细菌的流行病学特征
Epidemiological Characterization of Colistin and Carbapenem Resistant Enterobacteriaceae in a Tertiary: A Hospital from Anhui Province.
作者信息
Hameed Muhammad Fazal, Chen Yanan, Wang Ying, Shafiq Muhammad, Bilal Hazrat, Liu Linqing, Ma Jinming, Gu Pengying, Ge Honghua
机构信息
Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, 230601, People's Republic of China.
Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, 230036, People's Republic of China.
出版信息
Infect Drug Resist. 2021 Apr 6;14:1325-1333. doi: 10.2147/IDR.S303739. eCollection 2021.
PURPOSE
Antimicrobial resistance, especially carbapenem resistance Enterobacteriaceae and plasmid mediated mobile colistin resistance, is a serious issue worldwide. This study was designed to determine the epidemiological characteristics of plasmid mediated colistin resistance and carbapenem resistant Enterobacteriaceae from tertiary A hospital located in Hefei, China.
METHODS
Totally, 158 carbapenems resistant Enterobacteriaceae (CRE) were screened for antibiotic susceptibility, , extended spectrum β-lactamases (ESBLs), metallo-β-lactamases (MBLs), and fosfomycin resistance genes using PCR and sequencing. The sequence types were identified by multilocus sequence typing (MLST). Plasmid profiles were determined by PCR based replicon typing (PBRT), and the plasmid sizes were confirmed by southern blotting.
RESULTS
The isolates showed high MIC and MIC for all antimicrobials, except tigecycline, meropenem, and colistin. The main Carbapenemase genes were (90.5%), (3.7%), (5.6%) and (14.5%). The found 36.7%, (3.7%) recorded in six isolates. PBRT revealed in on IncR, IncFII, and IncA/C. in on IncFII, whereas in noticed on IncHI2 plasmid. was recorded among IncFIIK, IncFII, and IncF in , and . Resistance genes ( , ) harboring plasmids are successfully trans-conjugant to . A high incidence of ST11 was observed in carbapenem resistant isolates. While in , multiple STs were identified. However, in ST23 was identified for the first time in Anhui Province. Among , ST270 detected carrying . Southern-hybridization confirmed the plasmid sizes 35-150kb.
CONCLUSION
This study indicates the co-carrying of and among clinical isolates, the prevalence of different Enterobacteriaceae STs is alarming, especially in . Holding such a resistance profile is a threat for humans and animals, which may be transferred between the strains through plasmid transfusion. Persistent control actions are immediately necessary to combat this hazard.
目的
抗菌药物耐药性，尤其是碳青霉烯类耐药肠杆菌科细菌和质粒介导的可移动黏菌素耐药性，是全球范围内的一个严重问题。本研究旨在确定中国合肥一家三级甲等医院中质粒介导的黏菌素耐药性和碳青霉烯类耐药肠杆菌科细菌的流行病学特征。
方法
共筛选出158株碳青霉烯类耐药肠杆菌科细菌（CRE），采用PCR和测序技术检测其抗生素敏感性、超广谱β-内酰胺酶（ESBLs）、金属β-内酰胺酶（MBLs）和磷霉素耐药基因。通过多位点序列分型（MLST）鉴定序列类型。采用基于PCR的复制子分型（PBRT）确定质粒图谱，并通过Southern印迹法确认质粒大小。
结果
除替加环素、美罗培南和黏菌素外，分离株对所有抗菌药物均表现出高MIC和MIC。主要的碳青霉烯酶基因分别为 blaKPC（90.5%）、blaNDM（3.7%）、blaIMP（5.6%）和 blaOXA-48（14.5%）。blaNDM在36.7%的分离株中被发现，blaVIM（3.7%）在6株分离株中被记录。PBRT显示blaKPC存在于IncR、IncFII和IncA/C质粒上。blaNDM存在于IncFII质粒上，而blaIMP在IncHI2质粒上被发现。blaOXA-48在IncFIIK、IncFII和IncF质粒上被记录于不同分离株中。携带耐药基因（blaNDM、blaKPC）的质粒成功转移至受体菌。在碳青霉烯类耐药分离株中观察到ST11的高发生率。而在其他分离株中，鉴定出多种STs。然而，ST23中的blaNDM首次在安徽省被鉴定。在ST270中检测到携带blaOXA-48。Southern杂交证实质粒大小为35 - 150kb。
结论
本研究表明临床分离株中blaNDM和blaKPC的共携带情况，不同肠杆菌科STs的流行情况令人担忧，尤其是在blaNDM携带株中。保持这种耐药谱对人类和动物构成威胁，可能通过质粒转移在菌株间传播。立即采取持续的控制措施来应对这一危害是必要的。
Zotero 插件