耐碳青霉烯类药物的耐药基因及分子流行病学特征
Drug Resistance Genes and Molecular Epidemiological Characteristics of Carbapenem-Resistant .
作者信息
Liao Yiqun, Gong Junjie, Yuan Xiaoliang, Lu Hongfei, Jiang Lixia
机构信息
Department of Laboratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou, People's Republic of China.
Department of Respiratory Medicine, First Affiliated Hospital of Gannan Medical University, Ganzho, People's Republic of China.
出版信息
Infect Drug Resist. 2023 Mar 15;16:1511-1519. doi: 10.2147/IDR.S399142. eCollection 2023.
BACKGROUND
The global prevalence of carbapenem-resistant (CRKP) has become a serious challenge for nosocomial infection and attracted worldwide attention. This study explored the drug resistance genes and molecular characteristics for CRKP, providing a reference for nosocomial prevention and control.
METHODS
A total of 42 CRKP isolates were collected from the First Affiliated Hospital of Gannan Medical University (Ganzhou, China) from January 2018 to February 2021. The drug resistance of CRKP was tested by the VitekII Compact system. Drug resistance gene expression was detected by poly-merase chain reaction (PCR), and molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST).
RESULTS
All the 42 CRKP isolates were multi-drug resistant. Among them, 35 isolates (83.3%) produced bla and 12 isolates (28.6%) produced bla. The detection rate of bla and bla was 2.4% (1/42), respectively. Twelve isolates (28.6%) carried both bla and bla, one isolate (2.4%) carried both bla and bla, and one isolate (2.4%) carried bla, bla and bla. A variety of other extended-spectrum beta-lactamases (ESBLs) were also detected. All 42 isolates carried bla and bla, 27 isolates (64.3%) carried bla and 12 isolates (28.6%) carried bla. The MLST data classified the 42 CRKP isolates into 11 sequence types, mainly ST11, accounting for 61.9% (26/42), of which 92.3% of isolates (24/26) carrying bla. The PFGE results demonstrated that the 42 CRKP isolates could be divided into 20 clusters A-T, with cluster A (26.2%, 11/42) and cluster H (21.4%, 9/42) dominating, which were all ST11.
CONCLUSION
The CRKP isolates were severely multi-drug resistant, and the main resistant gene was bla production, carrying multiple ESBLs genes simultaneously. The MLST and PFGE revealed that the ST11-bla Klebsiella pneumoniae was the main clonotype. Our findings may offer help to antibiotics selection and nosocomial infection prevention and control.
背景
耐碳青霉烯类肺炎克雷伯菌（CRKP）的全球流行已成为医院感染的严峻挑战，并引起了全球关注。本研究探索了CRKP的耐药基因和分子特征，为医院感染的预防与控制提供参考。
方法
2018年1月至2021年2月期间，从赣南医学院第一附属医院（中国赣州）收集了42株CRKP分离株。采用VitekII Compact系统检测CRKP的耐药性。通过聚合酶链反应（PCR）检测耐药基因表达，并采用脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）进行分子分型。
结果
42株CRKP分离株均为多重耐药。其中，35株（83.3%）产生bla，12株（28.6%）产生bla。bla和bla的检出率分别为2.4%（1/42）。12株（28.6%）同时携带bla和bla，1株（2.4%）同时携带bla和bla，1株（2.4%）携带bla、bla和bla。还检测到多种其他超广谱β-内酰胺酶（ESBLs）。42株分离株均携带bla和bla，27株（64.3%）携带bla，12株（28.6%）携带bla。MLST数据将42株CRKP分离株分为11种序列型（ST），主要为ST11，占61.9%（26/42），其中92.3%的分离株（24/26）携带bla。PFGE结果表明，42株CRKP分离株可分为20个簇（A - T），其中簇A（26.
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