Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, No. 16992 Jingshi Road, Jinan 250014, Shandong Province, China.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
J Glob Antimicrob Resist. 2022 Mar;28:38-42. doi: 10.1016/j.jgar.2021.11.007. Epub 2021 Dec 8.
The global increase in carbapenem-resistant Enterobacteriaceae (CRE) is a growing health concern. Infections caused by CRE are associated with increased mortality and length of hospital stay, emphasising the health and economic burden posed by these pathogens. Although CRE can inhabit the human gut asymptomatically, colonisation with CRE is associated with an increased risk of CRE infection and mortality. In this study, we investigated the occurrence and characteristics of CRE in faecal samples from healthy persons in 12 villages in Shandong Province, China.
Screening for CRE in faecal samples was performed by selective cultivation. Minimum inhibitory concentrations (MICs) of meropenem were determined by the agar dilution method. Multilocus sequence typing (MLST) and carbapenemase gene carriage of the isolates were determined by whole-genome sequencing. Genetic relatedness of Escherichia coli isolates was determined by core genome MLST.
CRE carriage increased from 2.4% in 2015 to 13.4% in 2017. Most CRE isolates (93.0%) were E. coli and all carried NDM-type carbapenemases. Sequence types (STs) among the E. coli isolates were diverse. The single most common ST was the highly epidemic strain ST167, which was only observed in 2017.
We report a rapid increase in occurrence of CRE (from 2.4% to 13.4%) among faecal samples collected from healthy rural residents of Shandong Province from 2015 to 2017. Colonisation with CRE is known to increase the risk of CRE infection, and the worrying deterioration of the epidemiological situation in the region reported here indicates a need for further monitoring and possible interventions.
全球范围内耐碳青霉烯类肠杆菌科（CRE）的增加是一个日益严重的健康问题。由 CRE 引起的感染与死亡率和住院时间延长有关，强调了这些病原体带来的健康和经济负担。尽管 CRE 可以无症状地栖息在人类肠道中，但 CRE 的定植与 CRE 感染和死亡率增加有关。在这项研究中，我们调查了中国山东省 12 个村庄健康人群粪便样本中 CRE 的发生和特征。
通过选择性培养筛选粪便样本中的 CRE。通过琼脂稀释法测定美罗培南的最小抑菌浓度（MIC）。通过全基因组测序确定分离株的多位点序列分型（MLST）和碳青霉烯酶基因携带情况。通过核心基因组 MLST 确定大肠杆菌分离株的遗传相关性。
CRE 携带率从 2015 年的 2.4%增加到 2017 年的 13.4%。大多数 CRE 分离株（93.0%）为大肠杆菌，均携带 NDM 型碳青霉烯酶。大肠杆菌分离株的序列类型（ST）多种多样。最常见的 ST 是高度流行的 ST167，仅在 2017 年观察到。
我们报告了 2015 年至 2017 年期间从山东省农村健康居民粪便样本中 CRE （从 2.4%增加到 13.4%）的发生率迅速增加。已知 CRE 的定植会增加 CRE 感染的风险，这里报告的该地区令人担忧的流行病学情况恶化表明需要进一步监测和可能的干预措施。
