墨西哥 COVID-19 大流行期间革兰氏阴性菌中携带碳青霉烯酶基因和对多粘菌素耐药：Invifar 网络的研究结果。
Carbapenemase-Encoding Genes and Colistin Resistance in Gram-Negative Bacteria During the COVID-19 Pandemic in Mexico: Results from the Invifar Network.
机构信息
Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico.
出版信息
Microb Drug Resist. 2023 Jun;29(6):239-248. doi: 10.1089/mdr.2022.0226. Epub 2022 Dec 30.
In this study, we report the carbapenemase-encoding genes and colistin resistance in , , , and in the second year of the COVID-19 pandemic. Clinical isolates included carbapenem-resistant , carbapenem-resistant , carbapenem-resistant , and carbapenem-resistant . Carbapenemase-encoding genes were detected by PCR. Carbapenem-resistant and carbapenem-resistant isolates were analyzed using the Rapid Polymyxin NP assay. genes were screened by PCR. Pulsed-field gel electrophoresis and whole-genome sequencing were performed on representative isolates. A total of 80 carbapenem-resistant , 103 carbapenem-resistant , 284 carbapenem-resistant , and 129 carbapenem-resistant isolates were recovered. All carbapenem-resistant and carbapenem-resistant isolates were included for further analysis. A selection of carbapenem-resistant and carbapenem-resistant strains was further analyzed (86 carbapenem-resistant and 82 carbapenem-resistant ). Among carbapenem-resistant and carbapenem-resistant isolates, the most frequent gene was (86/103 [83.5%] and 72/80 [90%], respectively). For carbapenem-resistant , the most frequently detected gene was (52/86, 60.5%), and for carbapenem-resistant , was (19/82, 23.2%). For carbapenem-resistant , five indistinguishable pulsotypes were detected. Circulation of New Delhi metallo-β-lactamase (NDM) and NDM was detected in Mexico. High virulence sequence types (STs), such as ST307, ST167, ST111, and ST2, were detected. Among isolates, 18/101 (17.8%) were positive for the Polymyxin NP test (two, 11.0% positive for the gene, and one, 5.6% with disruption of the gene). All isolates were negative for the Polymyxin NP test. In conclusion, NDM and NDM were detected in Mexico, with the circulation of highly virulent STs. These results are relevant in clinical practice to guide antibiotic therapies considering the molecular mechanisms of resistance to carbapenems.
在这项研究中，我们报告了 COVID-19 大流行第二年的 、 、 、 和 中碳青霉烯酶编码基因和多粘菌素耐药性。临床分离株包括碳青霉烯耐药 、碳青霉烯耐药 、碳青霉烯耐药 、和碳青霉烯耐药 。通过 PCR 检测碳青霉烯酶编码基因。使用 Rapid Polymyxin NP assay 分析碳青霉烯耐药 和碳青霉烯耐药 分离株。通过 PCR 筛选 基因。对代表性分离株进行脉冲场凝胶电泳和全基因组测序。共回收 80 株碳青霉烯耐药 、103 株碳青霉烯耐药 、284 株碳青霉烯耐药 和 129 株碳青霉烯耐药 。所有碳青霉烯耐药 和碳青霉烯耐药 分离株均包含在进一步分析中。进一步分析了部分碳青霉烯耐药 和碳青霉烯耐药 菌株（86 株碳青霉烯耐药 和 82 株碳青霉烯耐药 ）。在碳青霉烯耐药 和碳青霉烯耐药 分离株中，最常见的基因是 （83.5%和 90%，分别为 86/103 [83.5%]和 72/80 [90%]）。对于碳青霉烯耐药 ，最常检测到的基因是 （52/86，60.5%），而对于碳青霉烯耐药 ，是 （19/82，23.2%）。对于碳青霉烯耐药 ，检测到五个无法区分的脉冲类型。在墨西哥检测到新德里金属β-内酰胺酶（NDM）和 NDM 的传播。检测到高毒力序列类型（STs），如 ST307、ST167、ST111 和 ST2。在 分离株中，18/101（17.8%）对多粘菌素 NP 试验呈阳性（两个，11.0%的 基因阳性，一个，5.6%的 基因中断）。所有 分离株对多粘菌素 NP 试验均呈阴性。总之，在墨西哥检测到 NDM 和 NDM，并且循环着高毒力的 STs。这些结果在临床实践中具有相关性，可指导考虑到碳青霉烯类抗生素耐药的分子机制的抗生素治疗。
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