Lack of polymyxin resistance among carbapenemase-producing Enterobacteriaceae in a university hospital in China
Lack of polymyxin resistance among carbapenemase-producing Enterobacteriaceae in a university hospital in China
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中国某大学医院产碳青霉烯酶肠杆菌科细菌缺乏多粘菌素耐药性
DOI：
10.1080/23744235.2017.1292543
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Patrice Nordmann
中科院分区：
文献类型：
--
作者：
Jiang Xiaofei;Poirel Laurent;Patrice Nordmann
我们感兴趣地阅读了本杂志最近发表的两篇文章，重点关注医院环境中产碳青霉烯酶肠杆菌科的升级，一篇来自中国浙江省[1]，另一篇来自北方意大利[2]。我国临床分离的肠杆菌多重耐药报告日益增多。不仅对碳青霉烯类抗生素的耐药性在上升，而且对其他临床相关抗生素如氟喹诺酮类、氨基糖苷类和磷霉素的共耐药性也在增加。因此，多粘菌素被认为是治疗多重耐药革兰氏阴性菌感染的最后手段抗生素。最近，在来自中国的动物、食物和患者的肠细菌中报告了质粒介导的粘菌素耐药性（MCR-1）[3]。除中国外，mcr-1基因在全球范围内的许多肠杆菌种属中均有传播报告[4]。此外，一个主要问题是在意大利[5]和最近在法国[6]观察到的耐碳青霉烯类和多粘菌素的医院内肺炎克雷伯菌分离株的传播。在大肠杆菌中观察到高质粒介导的mcr-1携带率。在中国，从生肉（15%）和动物（21%）中收集的大肠杆菌，但没有从住院患者（1%）中收集[3]。最近，在比利时报告了一种MCR-1的变异体，即MCR-2 [7]。考虑到在中国和其他地方广泛传播的产MCR-1菌株，迄今为止鉴定的与mcr-1基因相关的遗传结构的多样性，以及携带该基因的菌株的克隆背景的多样性，其传播可能与中国最近的事件无关。我们进行了一项回顾性研究，以评估多粘菌素耐药的发生率，
We read with interest two recent articles in the present journal focusing on escalation of carbapenamase-producing Enterobacteriaceae in the hospital environment, one from the Zhejing Province, China [1], and another from Northern Italy [2]. Multidrug resistance is increasingly reported in clinical enterobacterial isolates in China. Not only resistance to carbapenems is on the rise, but in addition co-resistance to other clinically-relevant antibiotics such as fluoroquinolones, aminoglycosides and fosfomycin is increasingly observed. Polymyxins are therefore considered as last resort antibiotics for treating infections due to multidrug-resistant Gram negatives. Recently, plasmid-mediated colistin resistance (MCR-1) was reported in enterobacterial from animals, food and patients from China [3]. Beyond China, the spread of the mcr-1 gene has been now reported worldwide in many enterobacterial species [4]. In addition, one of the major concern is the spread of carbapenem-and polymyxinresistant nosocomial Klebsiella pneumoniae isolates as observed in Italy [5] and more recently in France [6]. High plasmid-mediated mcr-1 carriage rate has been observed in E. coli collected from raw meat (15%) and animals (21%) in China, but not from inpatients (1%)[3]. Recently, a variant of MCR-1, namely MCR-2, has been reported from Belgium [7].Taking into account the wide spread MCR-1-producing strains in China and elsewhere, the diversity of genetic structures associated to the mcr-1 gene identified so far, and the diversity of the clonal backgrounds of the strains harboring that gene, it is likely that its spread does not correspond to a recent event in China. We have performed a retrospective study to evaluate the occurrence of polymyxin resistance and of the
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影响因子：
11.8
作者：
Nordmann P;Jayol A;Poirel L
通讯作者：
Poirel L
影响因子：
14.2
作者：
Capone, A.;Giannella, M.;Petrosillo, N.
通讯作者：
Petrosillo, N.
影响因子：
56.3
作者：
Liu, Yi-Yun;Wang, Yang;Shen, Jianzhong
通讯作者：
Shen, Jianzhong
影响因子：
9.4
作者：
Poirel, Laurent;Nordmann, Patrice
通讯作者：
Nordmann, Patrice
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影响因子：
5.8
作者：
Jianzhong Ye;Yapei Zhang;Chuanling Ma;Tieli Zhou
通讯作者：
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