Characterization of carbapenemases, extended spectrum β-lactamases and molecular epidemiology of carbapenem-non-susceptible Enterobacter cloacae in a Chinese hospital in Chongqing
Characterization of carbapenemases, extended spectrum β-lactamases and molecular epidemiology of carbapenem-non-susceptible Enterobacter cloacae in a Chinese hospital in Chongqing
复制标题
DOI：
10.1016/j.meegid.2012.10.010
复制
发表时间：
2013-03-01
影响因子：
3.2
通讯作者：
Zhang, Liping
中科院分区：
文献类型：
--
作者：
Dai, Wei;Sun, Shan;Zhang, Liping
碳青霉烯类耐药肠杆菌科，包括携带金属β-内酰胺酶（IMP、NDM或Vim）和非金属（KPC）碳青霉烯酶的多个菌种菌株，以及结合超广谱β-内酰胺酶（ESBL）和孔蛋白丢失的菌株，呈现出日益紧迫的临床危险。目的研究碳青霉烯类抗生素不敏感的阴沟肠杆菌产碳青霉烯酶和超广谱β-内酰胺酶的特性。Clobacillus）分离自中国教学医院。共获得986株非重复E.通过抗菌药物敏感性试验分析了2009年9月至2012年2月期间收集的阴沟肠杆菌分离株。采用PCR扩增和DNA测序方法检测碳青霉烯酶和ESBL基因。通过脉冲场凝胶电泳（PFGE）和树状图分析，克隆相关性进行了研究。结果表明，大肠杆菌CNSs的检出率为35/986，3.55%; clothing. 35株CNS大肠杆菌中检出碳青霉烯酶和ESBLs表型分别为9株（25.7%）和23株（65.7%）。Clobacillus strains分离株中分别检出KPC-2、IMP-8、IMP-26、NDM-1、TEM-6、CTX-M-3 '、CTX-M-14'和SHV-12型β-内酰胺酶3株（8.6%）、5株（14.3%）、1株（2.9%）、1株（2.9%）、13株（37.1%）、9株（25.7%）、8株（22.9%）和9株（25.7%）。重要的是，发现多个抗性基因在同一CNS E中共表达。梭菌分离物。PFGE和聚类分析表明，这些菌株的克隆多样性。本研究提示，碳青霉烯酶和超广谱β-内酰胺酶的过度产生共同作用于大肠埃希菌的中枢神经系统。在中国，此外，E.医院中的泄殖腔可能是通过多种耐药决定因素在不同克隆中的逐步积累而产生的。CNS E. Clobacterium分离物不是由克隆传播引起的。最重要的是，我们发现了一个中枢神经系统E。共表达IMP-26和NDM-1的Closophy分离物，这是我们所知的第一个报道。这也是中国大陆首次报道产NDM-1的肠杆菌科细菌。(C)2012爱思唯尔有限公司版权所有。
Carbapenem-resistant Enterobacteriaceae, including strains from multiple species harboring metallo-beta-lactamases (IMP, NDM or VIM) and non-metallo (KPC) carbapenemases, as well as those combining an extended-spectrum beta-lactamase (ESBL) enzyme with porin loss, present an increasingly urgent clinical danger. The aim of this study was to characterize the carbapenemases and ESBLs in carbapenem-non-susceptible (CNS) Enterobacter cloacae (E. cloacae) isolates from a Chinese teaching hospital. A total of 986 non-duplicated E. cloacae isolates collected between September 2009 and February 2012 were analyzed via antimicrobial susceptibility testing. Carbapenemase and ESBL genes were examined using PCR amplification and DNA sequencing. Clonal relatedness was investigated by pulsed-field gel electrophoresis (PFGE) and dendrogram analysis. We demonstrated that CNSs were prevalent (35/986, 3.55%) in E. cloacae. Phenotypes of carbapenemases and ESBLs were respectively found in 9 (25.7%) and 23 (65.7%) of the 35 CNS E. cloacae strains. KPC-2, IMP-8, IMP-26, NDM-1, TEM-6, CTX-M-3', CTX-M-14' and SHV-12 type beta-lactamases were identified in 3 (8.6%), 5 (14.3%), 1 (2.9%), 1 (2.9%), 13 (37.1%), 9 (25.7%), 8 (22.9%) and 9 (25.7%) isolates, respectively. Importantly, multiple resistance genes were found to be co-expressed in the same CNS E. cloacae isolates. PFGE and dendrogram analysis showed clonal diversity among these isolates. Our study suggested that over-production of carbapenemases and ESBLs contributed together to the CNS of E. cloacae in China. Furthermore, the decreased susceptibility to carbapenems in E. cloaca in the hospital might arise via stepwise accumulations of multiple drug-resistance determinants in different clones. The prevalence of CNS E. cloacae isolates was not caused by clonal dissemination. Most importantly, we identified a CNS E. cloacae isolate co-expressing IMP-26 and NDM-1, which is the first reported to the best of our knowledge. This is also the first report of NDM-1-producing Enterobacteriaceae in mainland China. (C) 2012 Elsevier B.V. All rights reserved.