Carbapenem-resistant Enterobacteriaceae resistant gene in Wuhan

doi:10.3877/cma.j.issn.1674-1358.2017.04.008

Abstract

Abstract:

Objective

To investigate the major resistance gene product carbapenemases Enterobacteriaceae in Wuhan, and to analyze the mechanism of resistance to carbapenem-resistant preliminary.

Method

Caries NP test was used to confirm the resistant phenotype of 88 strains of carbapenem-resistant antimicrobial agents Enterobacteriaceae. The KPC, NDM, VIM, IMP and OXA-48 carbapenemase resistance genes were detected by PCR and then sequenced.

Results

Total of 88 clinical isolates of cefazolin and ampicillin resistance rates were all 100.0%, while to piperacillin, ampicillin/sulbactam, amoxicillin/clavulanate, piperacillin/tazobactam, ceftazidime, cefotaxime, cefepime and imipenem were more than 90.0%. Carba NP test positive strains of 76 strains (86.4%), among which, 11 strains were weakly positive. Twenty-four strains of NDM-1 resistant gene were detected, 24 strains were resistant to KPC-2 carbapenemase, 14 strains were detected including IMP-1 resistance gene, 9 strains were detected including VIM-1 resistance gene, OXA-48 resistant gene was not detected. Four strains of Klebsiella pneumoniae combined with KPC and NDM genes, two strains of Enterobacter cloacae combined with NDM and VIM genes.

Conclusions

In Wuhan, Enterobacteriaceae carbapenem resistance mechanisms to antimicrobial agents mainly carrying NDM-1 and KPC-2 type carbapenem enzyme gene.

Key words: Resistance gene, Carbapenemases, Enterobacteriaceae

Yongwen Yang, Congrong Li, Zhen Li, Yuehua Pan, Lina Feng, Haojun Chen, Jing Guo. Carbapenem-resistant Enterobacteriaceae resistant gene in Wuhan[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(04): 352-358.

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https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2017/V11/I04/352

Figures/Tables 11

References 26

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引物名称	引物序列（3′→5′）	煺火温度（℃）	产物长度（bp）	引物来源
KPC-F	TCGCTAAACTCGAACAGG	63	785	参考文献^[8]
KPC-R	TTACTGCCCGTTGACGCCCAATCC	63	785	参考文献^[8]
NDM-F	TTGGCCTTGCTGTCCTTG	60	89	参考文献^[8]
NDM-R	ACACCAGTGACAATATCACCG	60	89	参考文献^[8]
VIM-F	AAGTCCGTTAGCCCATTCCG	59	114	NCBI数据库在线设计
VIM-R	GCGATATGCGACCAAACACC	59	114	NCBI数据库在线设计
IMP-F	GGGCGTTGTTCCTAAACATGG	61	185	NCBI在线设计
IMP-R	TAAGCCACTCTATTCCGCCC	61	185	NCBI在线设计
OXA-F	TTGGTGGCATCGATTATCGG	60	743	参考文献^[9]
OXA-R	GAGCACTTCTTTTGTGATGGC	60	743	参考文献^[9]

引物名称	引物序列（3′→5′）	煺火温度（℃）	产物长度（bp）	引物来源
KPC-F	TCGCTAAACTCGAACAGG	63	785	参考文献^[8]
KPC-R	TTACTGCCCGTTGACGCCCAATCC	63	785	参考文献^[8]
NDM-F	TTGGCCTTGCTGTCCTTG	60	89	参考文献^[8]
NDM-R	ACACCAGTGACAATATCACCG	60	89	参考文献^[8]
VIM-F	AAGTCCGTTAGCCCATTCCG	59	114	NCBI数据库在线设计
VIM-R	GCGATATGCGACCAAACACC	59	114	NCBI数据库在线设计
IMP-F	GGGCGTTGTTCCTAAACATGG	61	185	NCBI在线设计
IMP-R	TAAGCCACTCTATTCCGCCC	61	185	NCBI在线设计
OXA-F	TTGGTGGCATCGATTATCGG	60	743	参考文献^[9]
OXA-R	GAGCACTTCTTTTGTGATGGC	60	743	参考文献^[9]

抗菌药物	耐药（R）		中介（I）		敏感（S）
抗菌药物	菌株数	耐药率（%）	菌株数	中介率（%）	菌株数	敏感率（%）
氨苄西林	88	100.0	0	0.0	0	0.0
哌拉西林	87	98.8	0	0.0	1	1.2
阿莫西林/克拉维酸	86	97.7	0	0.0	2	2.3
氨苄西林/舒巴坦	85	96.6	3	3.4	0	0.0
哌拉西林/他唑巴坦	81	92.0	2	2.3	5	5.7
头孢唑啉	88	100.0	0	0.0	0	0.0
头孢他啶	82	93.2	0	0.0	6	6.8
头孢噻肟	86	97.7	0	0.0	2	2.3
头孢吡肟	84	95.5	1	1.1	3	3.4
氨曲南	75	85.2	0	0.0	13	14.8
亚胺培南	80	90.9	7	8.0	1	1.1
美洛培南	69	78.4	4	4.5	15	17.0
阿米卡星	39	44.3	0	0.0	49	55.7
庆大霉素	69	78.4	0	0.0	19	21.6
环丙沙星	68	77.3	0	0.0	20	22.7
左旋氧氟沙星	69	78.7	2	2.1	17	19.1
复方新诺明	37	42.0	0	0.0	51	58.0
氯霉素	54	61.0	12	13.4	23	25.6

抗菌药物	耐药（R）		中介（I）		敏感（S）
抗菌药物	菌株数	耐药率（%）	菌株数	中介率（%）	菌株数	敏感率（%）
氨苄西林	88	100.0	0	0.0	0	0.0
哌拉西林	87	98.8	0	0.0	1	1.2
阿莫西林/克拉维酸	86	97.7	0	0.0	2	2.3
氨苄西林/舒巴坦	85	96.6	3	3.4	0	0.0
哌拉西林/他唑巴坦	81	92.0	2	2.3	5	5.7
头孢唑啉	88	100.0	0	0.0	0	0.0
头孢他啶	82	93.2	0	0.0	6	6.8
头孢噻肟	86	97.7	0	0.0	2	2.3
头孢吡肟	84	95.5	1	1.1	3	3.4
氨曲南	75	85.2	0	0.0	13	14.8
亚胺培南	80	90.9	7	8.0	1	1.1
美洛培南	69	78.4	4	4.5	15	17.0
阿米卡星	39	44.3	0	0.0	49	55.7
庆大霉素	69	78.4	0	0.0	19	21.6
环丙沙星	68	77.3	0	0.0	20	22.7
左旋氧氟沙星	69	78.7	2	2.1	17	19.1
复方新诺明	37	42.0	0	0.0	51	58.0
氯霉素	54	61.0	12	13.4	23	25.6

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