Department of Microbiology, Faculty of Medicine, Nutrition Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran.
Department of Medical Laboratory Sciences, School of Paramedicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran.
J Med Case Rep. 2021 Nov 25;15(1):567. doi: 10.1186/s13256-021-03160-2.
Escherichia coli has appeared as an important opportunistic pathogen responsible for nosocomial infections in patients with immunodeficiency, particularly in leukemia patients. New Delhi metallo-beta-lactamase is an enzyme originally found in Enterobacteriaceae.
In this study, 80 isolates of Escherichia coli and Klebsiella pneumoniae were collected over the course of 2 years from two medical centers in Tehran, Iran. Production of carbapenemase was detected in the isolates using modified Hodge test. New Delhi metallo-beta-lactamase-1 genes were detected by polymerase chain reaction amplification with specific primers. Two New Delhi metallo-beta-lactamase-1-producing Escherichia coli strains were isolated from two Iranian patients with leukemia. These two patients were 6 and 15 years old, one female and the other male, from two oncology centers in Iran. The isolates were resistant to carbapenems (imipenem, meropenem), and two isolates were positive for carbapenemase production by modified Hodge test.
The emergence of New Delhi metallo-beta-lactamase-1-producing Escherichia coli is a threat for leukemia patients in oncology and hematology departments. We conclude that the incidence of multidrug resistant pathogens has increased among patients with leukemia and is life threatening.
大肠杆菌已成为导致免疫功能低下患者（尤其是白血病患者）院内感染的重要机会致病菌。新德里金属β-内酰胺酶最初在肠杆菌科中发现。
在这项研究中，在 2 年内从伊朗德黑兰的两个医学中心收集了 80 株大肠杆菌和肺炎克雷伯菌。使用改良 Hodge 试验检测分离株中产碳青霉烯酶的情况。通过使用特异性引物的聚合酶链反应扩增检测新德里金属β-内酰胺酶-1 基因。从两名患有白血病的伊朗患者中分离出两株产新德里金属β-内酰胺酶-1 的大肠杆菌菌株。这两名患者分别为 6 岁和 15 岁，一男一女，来自伊朗的两个肿瘤中心。分离株对碳青霉烯类药物（亚胺培南、美罗培南）耐药，两种分离株改良 Hodge 试验均产碳青霉烯酶。
产新德里金属β-内酰胺酶-1 的大肠杆菌的出现对肿瘤和血液科的白血病患者构成威胁。我们得出结论，白血病患者的多药耐药病原体的发生率增加，且具有生命威胁。
