Clinical infection characteristics and their drug resistance genes of carbapenem-resistant Enterobacteriaceae in a hospital of Shandong

doi:10.3969/j.issn.1673-8640.2020.08.004

Abstract

Abstract:

Objective To investigate the clinical infection characteristics,drug susceptibility and drug resistance genotypes of carbapenem-resistant Enterobacteriaceae（CRE） in the Affiliated Hospital of Jining Medical University,and to provide a reference for the prevention and treatment of CRE infection and the management of multi-drug resistant bacteria. Methods Totally,93 isolates of CRE were collected,bacterial identification and drug susceptibility tests were carried out by VITEK2 Compact automatic microbial identification and drug susceptibility system,and the isolates were confirmed by automatic rapid microbial mass spectrometry. Carbapenemase was confirmed by simplified carbapenem inactivation method（sCIM） phenotype confirmation test. Carbapenemase models were determined and identified by Xpert Carba-R. Carbapenemase resistance gene was amplified by polymerase chain reaction（PCR） and sequenced. Results CRE isolates were mainly isolated from sputum,blood and urine samples. CRE isolates were mainly distributed in intensive care unit. CRE isolates were resistant to 24 commonly used antibiotics and sensitive to tigecycline. Totally,79 isolates were positive for carbapenemase phenotype by sCIM phenotype confirmation test. Xpert Carba-R showed that there were 38 isolates of KPC gene positive,31 isolates of NDM gene positive,6 isolates of IMP gene positive and 4 isolates of NDM+KPC gene positive. A total of 38 isolates carrying KPC resistance genes,31 isolates carrying NDM resistance genes,6 isolates carrying IMP resistance genes and 4 isolates carrying KPC + NDM resistance genes. VIM and OXA-48 resistance genes were not determined. Conclusions CRE in the Affiliated Hospital of Jining Medical University is resistant to many commonly used antibiotics,but it has good drug susceptibility to tigecycline in vitro. The carbapenem-resistant gene of Klebsiella pneumoniae is mainly KPC type,and that of Escherichia coli is mainly NDM type. The surveillance should be strengthened to prevent its outbreak and nosocomial epidemic.

Key words: Carbapenem-resistant Enterobacteriaceae, Clinical infection characteristic, Drug resistance gene

CLC Number:

R446.1

LU Shuhua, LI Xiaozhe, LIU Lingyun, JIN Chengqiang, GE Ningning, DONG Haixin. Clinical infection characteristics and their drug resistance genes of carbapenem-resistant Enterobacteriaceae in a hospital of Shandong[J]. Laboratory Medicine, 2020, 35(8): 757-762.

Figures/Tables 4

References 13

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基因名称	引物序列（3'~5'）	退火温度/℃	产物长度/bp
KPC	F：TCGCTAAACTCGAACAGG	63	785
	R：TTACTGCCCGTTGACGCCCAATCC	63	785
NDM	F：TTGGCCTTGCTGTCCTTG	60	89
	R：ACACCAGTGACAATATCACCG	60	89
VIM	F：AAGTCCGTTAGCCCATTCCG	59	114
	R：GCGATATGCGACCAAACACC	59	114
IPM	F：GGGCGTTGTTCCTAAACATGG	61	185
	R：TAAGCCACTCTATTCCGCCC	61	185
OXA	F：TTGGTGGCATCGATTATCGG	60	743
	R：GAGCACTTCTTTTGTGATGGC	60	743

基因名称	引物序列（3'~5'）	退火温度/℃	产物长度/bp
KPC	F：TCGCTAAACTCGAACAGG	63	785
	R：TTACTGCCCGTTGACGCCCAATCC	63	785
NDM	F：TTGGCCTTGCTGTCCTTG	60	89
	R：ACACCAGTGACAATATCACCG	60	89
VIM	F：AAGTCCGTTAGCCCATTCCG	59	114
	R：GCGATATGCGACCAAACACC	59	114
IPM	F：GGGCGTTGTTCCTAAACATGG	61	185
	R：TAAGCCACTCTATTCCGCCC	61	185
OXA	F：TTGGTGGCATCGATTATCGG	60	743
	R：GAGCACTTCTTTTGTGATGGC	60	743

抗菌药物	敏感	中介	耐药
替加环素	100	0	0
头孢唑啉	0	0	100
氨苄西林	0	0	100
氨苄西林-舒巴坦	0	0	100
替卡西林-克拉维酸	0	0	100
阿米卡星	0	0	100
头孢曲松	0	0	100
亚胺培南	0	0	100
美洛培南	0	0	100
头孢噻肟	0	0	100
哌拉西林	0	0	100
哌拉西林-他唑巴坦	0	0	100
厄他培南	0	0	100
氨曲南	11.83	6.45	81.72
复方磺胺甲噁唑	47.31	0	52.69
环丙沙星	25.81	4.30	69.89
左氧氟沙星	45.16	0	54.84
庆大霉素	25.81	0	74.19
头孢吡肟	0	13.41	88.17
头孢哌酮-舒巴坦（纸片扩散法）	0	13.41	88.17
头孢他啶	0	3.23	96.77
头孢替坦	34.41	0	65.59
妥布霉素	18.28	3.23	78.49
四环素	11.83	0	88.17

抗菌药物	敏感	中介	耐药
替加环素	100	0	0
头孢唑啉	0	0	100
氨苄西林	0	0	100
氨苄西林-舒巴坦	0	0	100
替卡西林-克拉维酸	0	0	100
阿米卡星	0	0	100
头孢曲松	0	0	100
亚胺培南	0	0	100
美洛培南	0	0	100
头孢噻肟	0	0	100
哌拉西林	0	0	100
哌拉西林-他唑巴坦	0	0	100
厄他培南	0	0	100
氨曲南	11.83	6.45	81.72
复方磺胺甲噁唑	47.31	0	52.69
环丙沙星	25.81	4.30	69.89
左氧氟沙星	45.16	0	54.84
庆大霉素	25.81	0	74.19
头孢吡肟	0	13.41	88.17
头孢哌酮-舒巴坦（纸片扩散法）	0	13.41	88.17
头孢他啶	0	3.23	96.77
头孢替坦	34.41	0	65.59
妥布霉素	18.28	3.23	78.49
四环素	11.83	0	88.17

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