Molecular characterization and epidemiology of carbapenem non-susceptible Enterobacteriaceae isolated from the Eastern region of Heilongjiang Province, China

作者：Xue Gong, Jisheng Zhang, Shanshan Su, Yanjun Fu, Mingjia Bao, Yong Wang, Xiaoli Zhang · 发表于：BMC Infectious Diseases · 年份：2018 · DOI：10.1186/s12879-018-3294-3 · 被引用次数：41 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotics Pharmacokinetics and Efficacy、Infections and bacterial resistance

The aim of this study was to elucidate the molecular epidemiology of carbapenem non-susceptible Enterobacteriaceae(CNSE) isolated in the Eastern region of Heilongjiang Province, China, and the mechanism of carbapenem resistance. A total of 53 CNSE isolates were collected in a grade-3 hospital in Heilongjiang province. Sensitivity to antibiotics was determined using the VITEK-2 Compact automatic system. The modified Hodge test (MHT) and modified carbapenem inactivation test (mCIM) were performed for phenotypic identification. Beta-lactamases gene were detected by Polymerase chain reaction(PCR) and DNA sequencing. The transfer of bla NDM and bla KPC was investigated through conjugation experiment. The clinical data of patients were retrospectively reviewed. Homology of Carbapenem-resistant Klebsiella pneumoniae (CRKP) was conducted by multilocus sequence typing (MLST). CNSE were highly resistant to the majority of antimicrobial agents. The resistance rate was 100% for first, third, fourth generation cephalosporins and enzyme inhibitor compounds. Gentamicin and tobramycin recorded a resistance rate higher than 80%. Less than 30% resistance was detected for amikacin and levofloxacin. Among CNSE 52(98.1%) and 48(90.6%) of CNSE were positive for mCIM and MHT respectively. There were 42 positive bla KPC genes, three bla NDM-1 genes, three bla NDM-5 genes, one bla NDM-7 gene, and six bla IMP-4 genes. Most isolates harbored multiple drug resistance gene, especially as related to exten...