Molecular Characterization of Carbapenem-Resistant Enterobacter cloacae in 11 Chinese Cities.
Molecular Characterization of Carbapenem-Resistant Enterobacter cloacae in 11 Chinese Cities.
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DOI：
10.3389/fmicb.2018.01597
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发表时间：
2018
影响因子：
5.2
通讯作者：
Wang H
中科院分区：
文献类型：
--
作者：
Jin C;Zhang J;Wang Q;Chen H;Wang X;Zhang Y;Wang H
耐碳青霉烯类肠杆菌科（CRE）通常对大多数抗生素具有耐药性。由这类细菌引起的感染具有高死亡率，并对临床管理和公共卫生构成严重威胁。阴沟肠杆菌在引起医院感染的肠杆菌科中排名第三。本研究对碳青霉烯类耐药大肠杆菌的分子特征进行了研究。调查了中国的霍乱弧菌。从2012年11月至2016年8月，55株非重复的碳青霉烯类耐药E.样本来自中国11个城市的12家医院。采用基质辅助激光解吸/电离飞行时间质谱对细菌进行鉴定。药敏试验采用琼脂稀释法。碳青霉烯酶和其他β-内酰胺酶基因的检测采用PCR和测序法。进行多位点序列分型和质粒接合试验。在55 E.结果表明，50株产NDM-1、NDM-5、IMP-4、IMP-26、IMP-1、KPC-2、VIM-1等8种碳青霉烯酶的菌株中，有1株产NDM-1、NDM-5、IMP-4、IMP-26、IMP-1、KPC-2、VIM-1。产碳青霉烯酶大肠杆菌中NDM-1占68.0%（34/50）。clothing.共鉴定出24种序列类型，其中ST 418最常见，占20%（11/55）。为了进一步研究，进行脉冲场凝胶电泳（PFGE）测定，以确定PFGE模式的菌株。这23个分离物共产生13个PFGE带型，被定为A-M型。其中8株为A型，其余15株为B-M型。观察到15个blaNDM−1阳性E.从深圳分离到的具有相同PFGE图谱（A型）的梭菌分离株提示了一次普通菌株的传播暴发。还进行了S1核酸酶PFGE和Southern印迹以估计blaNDM−1阳性菌株所携带的质粒的大小。结果表明，携带blaNDM−1基因的质粒大小范围约为52-58个酶。我们的研究表明，碳青霉烯类耐药E。产NDM碳青霉烯酶的菌株耐药性较强。迫切需要及早发现和监测这些菌株的流行情况。
Carbapenem-resistant Enterobacteriaceae (CRE) are usually resistant to most of antibiotics. Infections caused by such bacteria have a high mortality and pose a serious threat to clinical management and public health. Enterobacter cloacae ranks third among Enterobacteriaceae that cause nosocomial infections. In this study, the molecular characteristics of carbapenem-resistant E. cloacae in China were investigated. From November 2012 to August 2016, 55 non-repetitive strains of carbapenem-resistant E. cloacae were collected from 12 hospitals in 11 Chinese cities. The bacteria were identified with matrix-assisted laser desorption/ionization time of flight mass spectrometry. Antimicrobial susceptibility tests were determined by agar dilution method. Carbapenemase and other β-lactamase genes were detected with PCR and sequencing. Multilocus sequence typing and plasmid conjugation tests were performed. Among the 55 E. cloacae strains, 50 strains were detected to produce 8 types of carbapenemase including NDM-1, NDM-5, IMP-4, IMP-26, IMP-1, KPC-2, and VIM-1. NDM-1 accounted for 68.0% (34/50) among the carbapenemase-producing E. cloacae. A total of 24 sequence types were identified and ST418 was the most common, accounting for 20% (11/55). For further investigation, a pulsed-field gel electrophoresis (PFGE) assay was conducted to identify the PFGE patterns of the strains. These 23 isolates yielded 13 PFGE patterns, which were designated as type A–M. Eight isolates obtained from Shenzhen had the same PFGE pattern (type A) and the remaining 15 isolates belonged to the other 12 PFGE patterns (type B–M). The observation that 8 of the 15 blaNDM−1-positive E. cloacae isolates obtained from Shenzhen with the same PFGE pattern (type A) suggested a transmission outbreak of a common strain. S1-nuclease PFGE and Southern blotting were also conducted to estimate the size of plasmids harbored by blaNDM−1-positive strains. The results showed that the plasmids harboring the blaNDM−1 gene ranged in size from approximately 52–58 kilobases. Our study indicates that carbapenem-resistant E. cloacae strains that produce NDM carbapenemase have strong resistance. Early detection and monitoring of the prevalence of these strains are urgent.
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