Mahajan Pooja, Kumar Mahadevan, Bhalla Gurpreet Singh, Tandel Kundan
Microbiologist, 92 Base Hospital, C/o 56 APO, India.
Professor (Microbiology), Bharati Vidyapeeth University Medical College, Pune, India.
Med J Armed Forces India. 2025 May-Jun;81(3):301-306. doi: 10.1016/j.mjafi.2024.02.004. Epub 2024 Apr 8.
Multi-drug resistant Enterobacterales increasingly isolated in hospital settings have a significant impact on therapy and overall treatment costs. Conjugative plasmids carrying relevant resistance genes have been described as the most frequent mechanism of acquisition and spread of resistance. PCR-based replicon typing (PBRT) is a method for plasmid identification and incompatibility typing which helps detect the presence of plasmid families in these bacteria. This study was undertaken to provide an insight into the prevalence of resistance plasmids in MDR Enterobacterales in our tertiary care setting.
A selection of one hundred multi-drug resistant Enterobacterale isolates sourced from clinical samples were subjected to PCR-based replicon typing.
A total of 21 plasmid replicon types were detected from 85% of the isolates out of the 28 families described in literature. Majority of the isolates (54%) showed three or more replicons. IncF was the most frequent plasmid family detected with FIA being the most common replicon type (43%) followed by FII (29%) and FIB (28%) replicons. Among the IncX plasmid family, X3 replicon was the commonest (14%). IncF and IncX plasmid families are known to carry a large spectrum of resistance genes.
The presence of these plasmids engenders emergent steps to be taken for prevention of their transmission in the form of strict infection control measures in the hospital and adoption of novel methods of plasmid curing to eliminate the plasmids from these organisms rendering them susceptible to the currently used antimicrobials.
在医院环境中日益分离出的多重耐药肠杆菌科细菌对治疗和总体治疗成本有重大影响。携带相关耐药基因的接合质粒已被描述为耐药性获得和传播的最常见机制。基于聚合酶链反应（PCR）的复制子分型（PBRT）是一种用于质粒鉴定和不相容性分型的方法，有助于检测这些细菌中质粒家族的存在。本研究旨在深入了解我们三级医疗机构中多重耐药肠杆菌科细菌耐药质粒的流行情况。
从临床样本中选取100株多重耐药肠杆菌科分离株进行基于PCR的复制子分型。
在文献中描述的28个家族中，从85%的分离株中总共检测到21种质粒复制子类型。大多数分离株（54%）显示出三种或更多种复制子。IncF是检测到的最常见质粒家族，其中FIA是最常见的复制子类型（43%），其次是FII（29%）和FIB（28%）复制子。在IncX质粒家族中，X3复制子最常见（14%）。已知IncF和IncX质粒家族携带大量耐药基因。
这些质粒的存在促使采取紧急措施，以严格的医院感染控制措施的形式预防其传播，并采用新的质粒消除方法从这些生物体中消除质粒，使其对目前使用的抗菌药物敏感。
