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耐碳青霉烯类肠杆菌科细菌临床分离株中16S rRNA甲基化酶基因的流行情况及分子特征

Prevalence and Molecular Characteristics of 16S rRNA Methylase Genes in Clinical Isolates of Carbapenem-Resistant Enterobacterales.

作者信息

Li Caiyun, Zhang Fa, Li Gang, Wang Wen

机构信息

Department of Clinical Laboratory, Nanjing Pukou People's Hospital, Nanjing, 211800, People's Republic of China.

Center of Medical Laboratory, General Hospital of Ningxia Medical University, Yinchuan, 750004, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Nov 21;17:5137-5145. doi: 10.2147/IDR.S483450. eCollection 2024.

Abstract

OBJECTIVE

To analyze the prevalence and molecular characteristics of 16S rRNA methylase genes in clinical isolates of carbapenem-resistant Enterobacterales, for clinical doctors provide a reference basis for the rational use of drugs.

METHODS

The Enterobacterales isolated from our hospital from 2020 to 2022 were selected and identified by VITEK 2 Compact automatic bacterial identification instrument. Resistance genes were detected by polymerase chain reaction.

RESULTS

A total of 180 carbapenem-resistant Enterobacterales were isolated, of which 158 (87.8%) were resistant to at least one aminoglycoside. The resistance rates to gentamicin, tobramycin and amikacin were 85.0%,82.8% and 54.4%, respectively. Compared with 16S rRNA methyltransferase negative isolates, the positive isolates were more sensitive to trimethoprim-sulfamethoxazole, tetracycline and minocycline, but had higher resistance rates to aztreonam, tobramycin, gentamicin, amikacin and ciprofloxacin. The resistance rates of 16S rRNA methyltransferase gene positive strains to most commonly used antibiotics were more than 80%. But the rates for colistin and tigecycline were less than 10%. There were 114 strains (63.3%) positive for 16S rRNA methyltransferase genes, mainly , accounting for 70.2%. The positive rates of other and + genes were 22.8%, 4.4% and 2.6%, respectively. No and genes were detected. In addition, 175 of the 180 carbapenem-resistant Enterobacterales carried at least one carbapenemase genes. The was the main one (115, 65.7%). There were 111 (61.7%) strains carried both carbapenemase and 16S rRNA methyltransferase genes, simultaneously. Compared with 16S rRNA methyltransferase negative strains, the positive strains carried more genes and less genes, with P values of 0.034 and 0.003, respectively.

CONCLUSION

and genes are the main resistance mechanisms of Enterobacterales to carbapenems and aminoglycosides in our hospital. It is necessary to strengthen the detection of multi-drug resistant strains to provide scientific basis for clinical rational drug use.

摘要

目的

分析耐碳青霉烯类肠杆菌科细菌临床分离株中16S rRNA甲基化酶基因的流行情况及分子特征,为临床医生合理用药提供参考依据。

方法

选取我院2020年至2022年分离的肠杆菌科细菌,采用VITEK 2 Compact全自动细菌鉴定仪进行鉴定。采用聚合酶链反应检测耐药基因。

结果

共分离出180株耐碳青霉烯类肠杆菌科细菌,其中158株(87.8%)对至少一种氨基糖苷类药物耐药。对庆大霉素、妥布霉素和阿米卡星的耐药率分别为85.0%、82.8%和54.4%。与16S rRNA甲基转移酶阴性分离株相比,阳性分离株对复方新诺明、四环素和米诺环素更敏感,但对氨曲南、妥布霉素、庆大霉素、阿米卡星和环丙沙星的耐药率更高。16S rRNA甲基转移酶基因阳性菌株对大多数常用抗生素的耐药率超过80%。但对黏菌素和替加环素的耐药率低于10%。16S rRNA甲基转移酶基因阳性菌株有114株(63.3%),主要为,占70.2%。其他和+基因的阳性率分别为22.8%、4.4%和2.6%。未检测到和基因。此外,180株耐碳青霉烯类肠杆菌科细菌中有175株携带至少一种碳青霉烯酶基因。主要为(115株,65.7%)。有111株(61.7%)菌株同时携带碳青霉烯酶和16S rRNA甲基转移酶基因。与16S rRNA甲基转移酶阴性菌株相比,阳性菌株携带更多的基因和更少的基因,P值分别为0.034和0.003。

结论

和基因是我院肠杆菌科细菌对碳青霉烯类和氨基糖苷类药物的主要耐药机制。有必要加强对多重耐药菌株的检测,为临床合理用药提供科学依据。

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