Molecular Characteristics of Carbapenem-Resistant Gram-Negative Bacteria in Southern China
Molecular Characteristics of Carbapenem-Resistant Gram-Negative Bacteria in Southern China
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DOI：
10.1089/mdr.2014.0085
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发表时间：
2015-04-01
影响因子：
2.6
通讯作者：
Rui, Yongyu
中科院分区：
文献类型：
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作者：
Zheng, Fen;Sun, Jingjing;Rui, Yongyu
收集对亚胺培南或美罗培南耐药的非复制革兰氏阴性菌368株，寻找碳青霉烯酶基因、1类整合子和带有共同区1的插入序列（ISCR1）。碳青霉烯酶基因bla（IMP-4）、bla（KPC-2）和bla（NDM-1）分别存在于2株肠杆菌科和7株铜绿假单胞菌、9株肺炎克雷伯菌、7株肠杆菌科和2株不动杆菌中。D类oxa型碳青霉烯酶基因bla（oxa -23样）、bla（oxa -24样）、bla（OXA-58样）和bla（oxa -51样）分别在不动杆菌59株（34.9%）、2株（1.2%）、16株（9.5%）和126株（74.6%）中检出。这是首次在贺氏肠杆菌和不动杆菌基因组种13TU中发现bla（NDM-1）。在整合酶阳性菌株中，通过5种、10种和4种不同的基因盒阵列分别鉴定出135株（90.0%）不动杆菌、22株（61.1%）铜绿假单胞菌和14株（100%）肠杆菌科菌株。在一些物种中首次报道了三个新的基因盒阵列：aadB-aadA1、dfrA25和dfrA16-aadA2。iscr1阳性菌株中，非发酵菌株（不动杆菌102株，铜绿假单胞菌13株）；3株肠杆菌科分离株含有相同排列的bla(PER-1)-推定谷胱甘肽- s -转移酶-新型ABC转运蛋白，3株肠杆菌科分离株含有3种不同排列的转运蛋白。观察到四种不同的复杂的1类整合子结构。在新德里检测到的复杂的1类整合子，产生金属- β -内酰胺酶（NDM-1）的E. hormaechei，在携带NDM-1的质粒中共存。结果提示，应重视严格实施感染控制措施，积极开展抗生素耐药性监测，避免产碳青霉烯酶革兰氏阴性菌的快速传播或暴发。
A total of 368 nonreplicate gram-negative bacteria with resistance to imipenem or meropenem were collected to search for carbapenemase genes, class 1 integrons, and insertion sequence with common region 1 (ISCR1). The carbapenemase genes bla(IMP-4), bla(KPC-2), and bla(NDM-1) were found in two Enterobacteriaceae and seven Pseudomonas aeruginosa isolates, nine Klebsiella pneumoniae isolates, and seven Enterobacteriaceae and two Acinetobacter spp. isolates. The class D OXA-type carbapenemase genes bla(OXA-23-like), bla(OXA-24-like), bla(OXA-58), and bla(OXA-51-like) were detected in 59 (34.9%), 2 (1.2%), 16 (9.5%), and 126 (74.6%) Acinetobacter strains. This is the first description of bla(NDM-1) in Enterobacter hormaechei and Acinetobacter genomic species 13TU. Of the integrase-positive strains, 135 (90.0%) Acinetobacter spp., 22 (61.1%) P. aeruginosa, and 14 (100%) Enterobacteriaceae isolates were identified by five, ten, and four different gene cassette arrays, respectively. Three novel gene cassette arrays aadB-aadA1, dfrA25, and dfrA16-aadA2 were reported for the first time in some species. Of the ISCR1-positive strains, the nonfermentative strains (102 Acinetobacter spp. and 13 P. aeruginosa. isolates) contained the same arrangement bla(PER-1)-putative glutathione-S-transferase-novel type ABC transporter, and three Enterobacteriaceae isolates harbored three different arrangements. Four distinct complex class 1 integron structures were observed. The complex class 1 integron detected in New Delhi, metallo-beta-lactamase (NDM-1)-producing E. hormaechei, was found to coexist in the NDM-1-carrying plasmid. Our results suggested that we should pay more attention to the strict implementation of infection control measures and active antibiotic resistance surveillance to avoid the rapid spread or outbreak of carbapenemase-producing gram-negative bacteria.