Yang Jinyoung, Baek Jin Yang, Ko Jae-Hoon, Huh Kyungmin, Cho Sun Young, Chung Doo Ryeon, Peck Kyong Ran, Huh Hee Jae, Ko Kwan Soo, Kang Cheol-In
Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, South Korea.
Microbiol Spectr. 2025 Feb 4;13(2):e0160424. doi: 10.1128/spectrum.01604-24. Epub 2024 Dec 31.
Carbapenem-resistant complex (CR-ECC), which is rapidly increasing as the cause of nosocomial infections, has limited treatment options. The aim of this study is to investigate the microbiological and clinical traits and molecular epidemiology of isolates of CR-ECC and provide guidance for antibiotic selection in clinical practice. Clinical CR-ECC isolates (ertapenem MIC ≥ 2 mg/L) were collected from 2021 to 2022. Species identification was performed using gene analysis, and antibiotic susceptibility tests were conducted by broth microdilution. The clinical characteristics of patients with CR-ECC isolates were retrospectively analyzed. Among the 108 CR-ECC isolates, 25 (23.2%) were non-susceptible to colistin, with colistin susceptibility being higher in compared to non-. isolates ( < 0.0001). Of the 108 CR-ECC isolates, 9 (8.3%) produced carbapenemases, and only 6 of the 22 colistin-resistant CR-ECC isolates (27.3%) harbored the gene. A total of 73 sequence types (STs), including 28 newly identified STs, were detected, demonstrating significant clonal diversity. The most common ST was ST74, known for its high prevalence and association with carbapenem resistance, with 77.8% identified as subsp. was more common in the colistin-susceptible group than in the non-susceptible group (88.0% vs 37.5%, < 0.0001), and was the only protective factor for colistin resistance (HR 0.089, CI 0.030-0.261, < 0.001). Although colistin resistance of CR-ECC is high, colistin could be administered safely to . It is imperative to maintain ongoing surveillance and to further research on CR-ECC.IMPORTANCEAlthough new antibiotics are being developed, there are still limited options for treating carbapenem-resistant complex (CR-ECC) in regions where their use is restricted. The resistance level to one of these options, colistin, was investigated using bacteria isolated from clinical samples. In clinical practice, colistin is frequently administered empirically without susceptibility testing. However, this study suggests that colistin can be safely administered to certain species such as within the CR-ECC.
耐碳青霉烯类肠杆菌科细菌复合体（CR-ECC）作为医院感染的病因正在迅速增加，其治疗选择有限。本研究的目的是调查CR-ECC分离株的微生物学和临床特征以及分子流行病学，并为临床实践中的抗生素选择提供指导。2021年至2022年收集了临床CR-ECC分离株（厄他培南MIC≥2mg/L）。使用基因分析进行菌种鉴定，通过肉汤微量稀释法进行药敏试验。对分离出CR-ECC的患者的临床特征进行回顾性分析。在108株CR-ECC分离株中，25株（23.2%）对黏菌素不敏感，黏菌素敏感性在[具体比较对象]中高于不敏感组（<0.0001）。在108株CR-ECC分离株中，9株（8.3%）产生碳青霉烯酶，在22株耐黏菌素的CR-ECC分离株中只有6株（27.3%）携带[具体基因]。共检测到73种序列类型（STs），包括28种新鉴定的STs，显示出显著的克隆多样性。最常见的ST是ST74，以其高流行率和与碳青霉烯耐药性的关联而闻名，77.8%被鉴定为[具体亚种]。[具体亚种]在黏菌素敏感组中比在不敏感组中更常见（88.0%对37.5%，<0.0001），并且是黏菌素耐药性的唯一保护因素（HR 0.089，CI 0.030 - 0.261，<0.001）。尽管CR-ECC对黏菌素的耐药性很高，但黏菌素可安全地用于[具体菌种]。必须持续进行监测并对CR-ECC进行进一步研究。重要性尽管正在研发新型抗生素，但在其使用受限的地区，治疗耐碳青霉烯类肠杆菌科细菌复合体（CR-ECC）的选择仍然有限。使用从临床样本中分离出的细菌对这些选择之一黏菌素的耐药水平进行了调查。在临床实践中，黏菌素经常在未进行药敏试验的情况下经验性使用。然而，本研究表明，黏菌素可安全地用于CR-ECC中的某些菌种，如[具体菌种]。
