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华南某脑科及精神专科医院耐碳青霉烯类肠杆菌科细菌的耐药性及流行病学分析

Drug Resistance and Epidemiological Analysis of Carbapenem-Resistant Enterobacteriaceae in a Brain and Psychiatric Hospital of South China.

作者信息

Yue Lei, Zhu Xiumei, Kuang Yuyan, Lin Yulong, Liu Haiying

机构信息

Clinical Laboratory, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.

Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.

出版信息

J Clin Lab Anal. 2025 Aug;39(15):e70073. doi: 10.1002/jcla.70073. Epub 2025 Jul 3.


DOI:10.1002/jcla.70073
PMID:40607763
Abstract

BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) has increasingly become a global health problem, and the drug resistance and epidemiology of its infection are important for disease prevention and control. METHODS: The CRE isolates detected in the hospital from July 2021 to April 2023 were collected, then the antibiotic sensitivity was detected by an automatic microbial analyzer. Polymerase chain reaction (PCR) was performed to detect carbapenem-resistance genes. The homology and epidemiological characteristics of the strains of Enterobacteriaceae were analyzed by repeated common sequence PCR(ERIC-PCR). RESULTS: A total of 94 non-repeating CRE isolates were collected mainly from the respiratory tract (67.02%) and urinary tract (22.34%). Among these, 73 strains (77.66%) were carbapenem-resistant Klebsiella pneumoniae (CRKP), while 21 strains (22.34%) were carbapenem-resistant Escherichia coli (CREC). Antibiotic susceptibility testing revealed a low resistance rate to tigecycline (2.13%). Analysis of CRE resistance genes demonstrated that blaKPC accounted for 93.15% of CRKP isolates (68/73), while blaNDM was present in 90.48% of CREC isolates (19/21). In the homology analysis, CRKP isolates were divided into five clusters with C type representing the majority at 80.82% prevalence (59/73). Similarly, CREC could be classified into four clusters with A type being predominant at 80.95% among the isolated strains (17/21). The detection of CRE strains involved multiple departments in two separate wards of this hospital, located approximately 28 km from each other. CONCLUSIONS: CRE infection in this hospital has high homology and wide distribution; it is necessary to strengthen prevention and control measures to control CRE nosocomial infection spread.

摘要

背景:耐碳青霉烯类肠杆菌科细菌(CRE)日益成为一个全球性的健康问题,其感染的耐药性及流行病学情况对疾病预防和控制至关重要。 方法:收集2021年7月至2023年4月在该医院检测到的CRE分离株,然后通过自动微生物分析仪检测抗生素敏感性。采用聚合酶链反应(PCR)检测碳青霉烯耐药基因。通过重复共有序列PCR(ERIC-PCR)分析肠杆菌科菌株的同源性和流行病学特征。 结果:共收集到94株非重复的CRE分离株,主要来自呼吸道(67.02%)和泌尿道(22.34%)。其中,73株(77.66%)为耐碳青霉烯肺炎克雷伯菌(CRKP),21株(22.34%)为耐碳青霉烯大肠埃希菌(CREC)。抗生素敏感性试验显示对替加环素的耐药率较低(2.13%)。CRE耐药基因分析表明,blaKPC在CRKP分离株中占93.15%(68/73),而blaNDM在CREC分离株中占90.48%(19/

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本文引用的文献

[1]
Transmission of clones of carbapenem-resistant Escherichia coli between a hospital and an urban wastewater treatment plant.

Environ Pollut. 2023-11-1

[2]
Epidemiological and Antimicrobial Resistant Patterns, and Molecular Mechanisms of Carbapenem-Resistant Infections in ICU Patients.

Infect Drug Resist. 2023-5-9

[3]
International Epidemiology of Carbapenemase-Producing Escherichia coli.

Clin Infect Dis. 2023-8-22

[4]
Antimicrobial resistance and molecular epidemiology of carbapenem-resistant Escherichia coli from urinary tract infections in Shandong, China.

Int Microbiol. 2023-11

[5]
Evaluation of ERIC-PCR and MALDI-TOF as typing tools for multidrug resistant Klebsiella pneumoniae clinical isolates from a tertiary care center in India.

PLoS One. 2022

[6]
Global spread of carbapenem-resistant Enterobacteriaceae: Epidemiological features, resistance mechanisms, detection and therapy.

Microbiol Res. 2023-1

[7]
Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant in Western Chongqing, China.

Front Cell Infect Microbiol. 2021

[8]
Carbapenemase-producing Enterobacterales infections: recent advances in diagnosis and treatment.

Int J Antimicrob Agents. 2022-2

[9]
Clinical Epidemiology, Risk Factors, and Control Strategies of Infection.

Front Microbiol. 2021-12-22

[10]
Emerging Carbapenem-Resistant Infection, Its Epidemiology and Novel Treatment Options: A Review.

Infect Drug Resist. 2021-10-21

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