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冈山大学医院产碳青霉烯酶肠杆菌科分离株的表型和遗传特征。

Phenotypic and Genetic Characteristics of Carbapenemase-Producing Enterobacterales Isolates at Okayama University Hospital.

机构信息

Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Department of Medical Laboratory Science, Graduate School of Health Sciences, Okayama University.

出版信息

Acta Med Okayama. 2024 Oct;78(5):371-376. doi: 10.18926/AMO/67657.

Abstract

Spread of carbapenemase-producing Enterobacterales (CPE) is an ongoing public health issue worldwide, including in Japan. In this study, we investigated the phenotypic and genetic characteristics of CPE isolates at Okayama University Hospital over the 5 years (2013-2018) prior to the outbreak of the 2019 coronavirus pandemic. Of 24 carbapenem-resistant Enterobacterales isolated during the study period, we identified 8 CPE isolates harboring blaIMP-1 (5 isolates) and blaIMP-6 genes (3 isolates). Bacterial species and carbapenem susceptibility patterns exhibited diversity. Minimum inhibitory concentrations (MICs) of meropenem were generally higher than those of imipenem and biapenem. Results of pulsed-field gel electrophoresis demonstrated that neither clonal nor plasmid-mediated outbreaks of blaIMP-harboring CPE isolates have developed at our hospital. One Klebsiella oxytoca isolate showed a high MIC (128 μg/mL) of meropenem, which could be explained by the high plasmid copy number. Subsequent analysis of this isolate may elucidate the intricacies of carbapenem resistance profiles among CPE isolates. Collectively, our findings underscore the necessity for ongoing genetic surveillance of CPE, complemented by tailored approaches for infection prevention and control.

摘要

产碳青霉烯酶肠杆菌科(CPE)的传播是一个全球范围内持续存在的公共卫生问题,包括在日本。在这项研究中,我们调查了冈山大学医院在 2019 年冠状病毒大流行爆发前的 5 年(2013-2018 年)期间 CPE 分离株的表型和遗传特征。在研究期间分离出的 24 株耐碳青霉烯肠杆菌中,我们鉴定出 8 株携带 blaIMP-1(5 株)和 blaIMP-6 基因的 CPE 分离株。细菌种类和碳青霉烯类药物敏感性模式表现出多样性。美罗培南的最低抑菌浓度(MIC)普遍高于亚胺培南和比阿培南。脉冲场凝胶电泳的结果表明,我们医院既没有发生 blaIMP 携带 CPE 分离株的克隆性爆发,也没有发生质粒介导的爆发。一株产酸克雷伯氏菌分离株对美罗培南的 MIC(128μg/mL)较高,这可以用高质粒拷贝数来解释。对该分离株的进一步分析可能阐明 CPE 分离株中碳青霉烯类药物耐药谱的复杂性。总的来说,我们的研究结果强调了对 CPE 进行持续遗传监测的必要性,同时还需要采取有针对性的感染预防和控制措施。

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