Molecular Analysis of the Antibiotic Resistant NDM-1 Gene in Clinical Isolates of Enterobacteriaceae
Molecular Analysis of the Antibiotic Resistant NDM-1 Gene in Clinical Isolates of Enterobacteriaceae
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DOI：
10.7754/clin.lab.2019.190727
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发表时间：
2020-01-01
影响因子：
0.7
通讯作者：
Younas, Sonia
中科院分区：
文献类型：
--
作者：
Ejaz, Hasan;Alzahrani, Badr;Younas, Sonia
背景资料：肠杆菌科中新的Dehli金属β-内酰胺酶（NDM）基因的出现是导致多重耐药的原因，该多重耐药是导致患者严重感染和严重发病的原因。我们的研究旨在确定的分子特征和NDM-1生产Enterobacteriaceae.Methods：我们分离出370个个体肠杆菌从临床标本收集的两个三级医院在Sakaka，沙特阿拉伯。使用标准微生物学技术和Phoenix和Microscan WalkAway Plus自动分析仪进行细菌分离。结果：在68株肠杆菌科细菌中检测到bla（NDM）基因，其中包括1株罕见的Cedecea lapagei。其中43株（63.2%）为bla（NDM-1），25株（36.8%）为bla（NDM）变异株。观察到NDM-1和肺炎克雷伯菌之间存在统计学显著相关性（p = 0.004），NDM变体之间的关系与弗氏柠檬酸杆菌（p = 0.02）和大肠埃希菌（p = 0.03）显著相关。产NDM肠杆菌科的体外最低抑菌浓度（MIC）显示对几组抗生素的抗生素耐药率非常高。这些细菌菌株对两种氨基糖苷类抗生素、庆大霉素（39; 57.3%）和阿米卡星（27; 39.7%），对替加环素的耐药性最低（25; 36.8%）。在我们的研究中，大量NDM-1肠杆菌的出现引起了医院和更广泛社区的广泛关注，给我们留下了一个狭窄的治疗选择：氨基糖苷类、复方新诺明和替加环素。
Background: The emergence of the New Dehli metallo-beta-lactamase (NDM) gene in Enterobacteriaceae is responsible for multidrug resistance responsible for severe infections and serious morbidity in patients. Our study aimed to define the molecular characteristics and antibiogram of the NDM-1 producing Enterobacteriaceae.Methods: We isolated 370 individual enterobacteria from the clinical specimens collected from the two tertiary hospitals in Sakaka, Saudi Arabia. Bacterial isolation was performed using standard microbiological techniques and the Phoenix and Microscan WalkAway Plus automated analyzers. Bacterial strains were characterized by phenotypic methods and PCR, and DNA sequencing was used for the molecular characterization of NDM genes.Results: The bla(NDM) gene was detected among the 68 members of the Enterobacteriaceae including a single case of rarely reported Cedecea lapagei. Of these 68, 43 isolates (63.2%) were bla(NDM-1) and 25 (36.8%) were bla(NDM) variants. A statistically significant relationship between the NDM-1 and Klebsiella pneumoniae (p = 0.004) was seen, and the relationship between the NDM variants was significantly associated with Citrobacter freundii (p = 0.02) and Escherichia coli (p = 0.03). The in vitro minimum inhibitory concentrations (MICs) of NDM-producing Enterobacteriaceae revealed a very high rate of antibiotic resistance against several groups of antibiotics. These bacterial strains were less resistant to two aminoglycosides, gentamicin (39; 57.3%) and amikacin (27; 39.7%), and showed minimum resistance to tigecycline (25; 36.8%).Conclusions: The emergence of a large number of NDM-1 enterobacteria in our study identifies a substantial public concern, both within hospitals and the wider community, and leaves us a narrow choice of therapeutic options: the aminoglycosides, co-trimoxazole, and tigecycline.