Department of Laboratory Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Laboratory Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Ann Lab Med. 2022 Jan 1;42(1):36-46. doi: 10.3343/alm.2022.42.1.36.
The emergence of carbapenemase-producing (CPE) represents a major clinical problem. Recently, the occurrence of CPE has increased globally, but epidemiological patterns vary across region. We report the trends in the genotypic distribution and antimicrobial susceptibility of CPE isolated from rectal and clinical samples during a four-year period.
Between January 2016 and December 2019, 1,254 nonduplicated CPE isolates were obtained from four university hospitals in Korea. Carbapenemase genotypes were determined by multiplex real-time PCR. Antimicrobial susceptibility was profiled using the Vitek 2 system (bioMérieux, Hazelwood, MO, USA) or MicroScan Walkaway-96 system (Siemens West Sacramento, CA, USA). The proportions of carbapenemase genotypes and nonsusceptibility were analyzed using Pearson's chi-square test.
Among the 1,254 CPE isolates, 486 (38.8%), 371 (29.6%), 357 (28.5%), 8 (0.6%), 8 (0.6%), and 24 (1.9%) were carbapenemase (KPC), oxacillinase (OXA)-48-like, New Delhi metallo-β-lactamase (NDM), imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), and multiple producers, respectively. The predominant species was (72.6%), followed by (6.5%). More than 90% of the isolates harboring , , and -like were nonsusceptible to cephalosporins, aztreonam, and carbapenems.
The impact of CPE is primarily due to KPC-, NDM-, and OXA-48-like-producing isolates. Isolates carrying these carbapenemase are mostly multidrug-resistant. Control strategies based on these genotypic distributions and antimicrobial susceptibilities of CPE isolates are required.
碳青霉烯酶产生菌（CPE）的出现是一个主要的临床问题。最近，CPE 在全球范围内的发生有所增加，但在不同地区的流行模式有所不同。我们报告了在四年期间从直肠和临床样本中分离出的 CPE 的基因型分布和抗菌药物敏感性的趋势。
在 2016 年 1 月至 2019 年 12 月期间，从韩国的四家大学医院获得了 1254 个非重复的 CPE 分离株。通过多重实时 PCR 确定碳青霉烯酶基因型。使用 Vitek 2 系统（bioMérieux，Hazelwood，MO，USA）或 MicroScan Walkaway-96 系统（Siemens West Sacramento，CA，USA）对抗菌药物敏感性进行分析。使用 Pearson 卡方检验分析碳青霉烯酶基因型和非敏感性的比例。
在 1254 株 CPE 分离株中，486 株（38.8%）、371 株（29.6%）、357 株（28.5%）、8 株（0.6%）、8 株（0.6%）和 24 株（1.9%）分别为碳青霉烯酶（KPC）、OXA-48 样、新德里金属-β-内酰胺酶（NDM）、亚胺培南酶（IMP）、维罗纳整合子编码金属-β-内酰胺酶（VIM）和多种生产者。主要物种是 （72.6%），其次是 （6.5%）。携带 、 、和 -样的分离株对头孢菌素、氨曲南和碳青霉烯类药物的耐药率均超过 90%。
CPE 的影响主要是由于 KPC、NDM 和 OXA-48 样产生菌引起的。携带这些碳青霉烯酶的分离株大多为多药耐药菌。需要根据这些 CPE 分离株的基因型分布和抗菌药物敏感性制定控制策略。
