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波兰一家单中心研究：从住院患者中分离出的耐碳青霉烯类菌株的发生情况及特征

Occurrence and Characteristics of Carbapenem-Resistant Strains Isolated from Hospitalized Patients in Poland-A Single Centre Study.

作者信息

Sarowska Jolanta, Choroszy-Krol Irena, Jama-Kmiecik Agnieszka, Mączyńska Beata, Cholewa Sylwia, Frej-Madrzak Magdalena

机构信息

Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland.

Department of Pharmaceutical Microbiology and Parasitology, Faculty of Pharmacy, Medical University, 50-367 Wroclaw, Poland.

出版信息

Pathogens. 2022 Jul 29;11(8):859. doi: 10.3390/pathogens11080859.

DOI:10.3390/pathogens11080859
PMID:36014980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9416609/
Abstract

The global emergence and spread of genes responsible for the production of ESBL (extended-spectrum beta-lactamases) and carbapenemases in isolates poses a serious threat to public health. The aim of this study was to retrospectively analyze the frequency of occurrence and drug resistance of selected alarm agents isolated from patients of the specialist hospital in Wrocław. A total of 13,528 clinical materials collected from patients of a specialist hospital in Wrocław were analyzed in the period from 1 January 2020 to 31 December 2020. Overall, 3894 bacterial strains were isolated from clinical materials, including 416 isolates. that showed resistance to ETP (ertapenem) and/or MEM (meropenem) were tested using phenotypic tests for the detection of KPC (carbapenemase-producing ), MBL (metallo-β-lactamase) and OXA-48 (oxacilinase-48) carbapenemases. In the case of a positive or doubtful result of the phenotypic test, immunochromatographic tests and the CarbaNP test were performed. In total, 58 isolates resistant to 1 or more carbapenem antibiotics were isolated. Of the 58 strains, 16 (27.6%) were isolated from rectal swabs conducted on CPE (carbapenemase-producing ) carriers. In the case of CRE (carbapenem-resistant ) , carbapenemases were detected in 28/58 (48.3%) isolates. Notably, 23/28 isolates produced MBL/NDM (New Delhi metallo-β-lactamase) (82.1%), 5/28 produced VIM (Verona-intergon-encoded metallo-β-lactamase) (14.3%), and one produced MBL/NDM + OXA-48. Carbapenemases were detected in 13 of 16 (81.3%) carbapenem-resistant isolates derived from rectal swabs. The significant participation of CRE and CPE isolates in the infections proves the need to test patients admitted to hospital wards for their status as a CPE carrier in order to limit the emergence of new epidemic outbreaks.

摘要

产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶的基因在全球范围内的出现和传播，对分离株构成了严重的公共卫生威胁。本研究的目的是回顾性分析从弗罗茨瓦夫专科医院患者中分离出的特定警示菌的发生频率和耐药性。2020年1月1日至2020年12月31日期间，对从弗罗茨瓦夫一家专科医院患者收集的13528份临床材料进行了分析。总体而言，从临床材料中分离出3894株细菌菌株，其中包括416株对厄他培南（ETP）和/或美罗培南（MEM）耐药的分离株，使用表型试验检测产KPC（碳青霉烯酶）、MBL（金属β-内酰胺酶）和OXA-48（氧青霉烯酶-48）碳青霉烯酶。如果表型试验结果为阳性或可疑，则进行免疫层析试验和CarbaNP试验。总共分离出58株对1种或多种碳青霉烯类抗生素耐药的分离株。在这58株菌株中，16株（27.6%）是从对产碳青霉烯酶（CPE）携带者进行的直肠拭子中分离出来的。对于耐碳青霉烯类肠杆菌科细菌（CRE），在58株分离株中有28株（48.3%）检测到碳青霉烯酶。值得注意的是，28株中有23株（82.1%）产生MBL/NDM（新德里金属β-内酰胺酶），5株（14.3%）产生VIM（维罗纳整合子编码金属β-内酰胺酶），1株产生MBL/NDM + OXA-48。从直肠拭子中分离出的16株耐碳青霉烯类分离株中有13株（81.3%）检测到碳青霉烯酶。CRE和CPE分离株在感染中的显著参与证明，有必要对入院病房的患者进行CPE携带者状态检测，以限制新的疫情爆发的出现。

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