Phenotypic and Genotypic Characterization of Carbapenem-resistant Enterobacteriaceae: Data From a Longitudinal Large-scale CRE Study in China (2012-2016)
Phenotypic and Genotypic Characterization of Carbapenem-resistant Enterobacteriaceae: Data From a Longitudinal Large-scale CRE Study in China (2012-2016)
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DOI：
10.1093/cid/ciy660
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发表时间：
2018-12-01
影响因子：
11.8
通讯作者：
Wang, Hui
中科院分区：
文献类型：
--
作者：
Wang, Qi;Wang, Xiaojuan;Wang, Hui
背景耐碳青霉烯类肠杆菌科（CRE）菌株是全球健康的主要威胁。有效的控制措施的发展需要更详细的CRE的表型和基因型特征。CRE分离株于2012年1月1日至2016年12月31日期间从中国25个省的65家医院收集。通过药敏试验和多位点序列分型对分离株进行鉴定。采用聚合酶链反应和DNA测序技术检测碳青霉烯酶、动员型粘菌素耐药（mcr-1）和β-内酰胺酶基因。研究期间共收集了1801株独立的CRE分离株（1201株肺炎克雷伯菌、282株大肠埃希菌和179株阴沟肠杆菌）。总体而言，分别有96.9%、89.7%、54.5%、49.9%和40%的CRE菌株对粘菌素、替加环素、阿米卡星、米诺环素和磷霉素敏感。1091/1201（91%）K.肺炎克雷伯氏菌225/282（80%）;大肠埃希菌129/179（72%）; Clopidin具有碳青霉烯酶基因。K.肺炎克雷伯氏菌产碳青霉烯酶（KPC）占优势。pneumoniae（77%），而新德里大肠杆菌中金属β-内酰胺酶（NDM）占优势。大肠杆菌（75%）和大肠杆菌（75%）。氯吡格雷（53%）。在13株携带NDM的大肠杆菌中检测到mcr-1基因。大肠埃希菌（4.6%）。序列类型（ST）11和ST 167在100 K中占优势。pneumoniae和47株E. coli STs。KPC-ST 11占K.肺炎分离株对氨曲南、磷霉素和阿米卡星的耐药水平高于非ST 11菌株（P <0.001）。从2012年到2016年，KPC和NDM酶在CRE中的比例增加（分别为54%-59%和12%-28%）。携带碳青霉烯酶的CRE菌株数量正在增加。KPC-ST11 K.肺炎，主要菌株，显示出对大多数可用抗生素的敏感性降低。
Background. Carbapenem-resistant Enterobacteriaceae (CRE) strains are a major threat to global health. The development of effective control measures requires more detailed phenotypic and genotypic characterization of CRE.Methods. CRE isolates were collected from 65 hospitals in 25 provinces across China between January 1, 2012, and December 31, 2016. The isolates were characterized by antimicrobial susceptibility testing and multilocus sequence typing. Genes encoding carbapenemases, mobilized colistin resistance (mcr-1), and beta-lactamases were detected by polymerase chain reaction and DNA sequencing.Results. A total of 1801 independent CRE isolates (1201 Klebsiella pneumoniae, 282 Escherichia coli, and 179 Enterobacter cloacae) were collected during the study period. Overall, 96.9%, 89.7%, 54.5%, 49.9%, and 40% of CRE strains were susceptible to colistin, tigecycline, amikacin, minocycline, and fosfomycin, respectively. Notably, 1091/1201 (91%) K. pneumoniae, 225/282 (80%) E. coli, and 129/179 (72%) E. cloacae harbored carbapenemase gene. K. pneumoniae carbapenemase (KPC) was predominant in K. pneumoniae (77%), whereas New Delhi metallo-beta-lactamase (NDM) was predominant in E. coli (75%) and E. cloacae (53%). The mcr-1 gene was detected in 13 NDM-carrying E. coli isolates (4.6%). Sequence type (ST) 11 and ST167 were predominant among the 100 K. pneumoniae and 47 E. coli STs, respectively. KPC-ST11, which accounted for 64% of K. pneumoniae isolates, had higher levels of resistance than non-ST11 strains to aztreonam, fosfomycin, and amikacin (P < .001). The proportions of KPC and NDM enzymes in CRE increased from 2012 to 2016 (54%-59% and 12%-28%, respectively).Conclusions. The number of CRE strains harboring carbapenemase is increasing. KPC-ST11 K. pneumoniae, the predominant strain, shows a reduced susceptibility to most available antibiotics.