Research on the mechanism of the New Delhi metallo-β-lactamase-1 possessing Klebsiella pneumoniae resistant to carbapenems among burn patients

作者：Fangling Du, Yanfang Mei, Panpan Liu, La‐Gen Wan, Dandan Wei, Xianwei Cao, Jiangxiong Wen, Tianxin Xiang · 发表于：Zhonghua jianyan yixue zazhi · 年份：2018 · DOI：10.3760/cma.j.issn.1009-9158.2018.01.008 · 研究领域：Antibiotic Resistance in Bacteria、Antibiotic Use and Resistance、Bacterial biofilms and quorum sensing

Objective To investigate the antimicrobial resistant mechanisms of high level carbapenem resistant Klebsiella pneumoniae infection of burn patients. Methods A retrospective study was conducted on totally 18 non-repetitive high level CR-KP which were isolated from burn patients hospitalized between July 2014 and June 2015. MIC of antibiotics were determined by using the GN13 cards and agar dilution method. The specific PCR and DNA sequence analysis were performed to confirm the β-lactamase type. Plasmid conjugation transfer experiments and southem hybridization were applied to study the mode of carbapenem resistance transmission. Outer membrane proteins (Omps) were isolated and examined by PCR and (sodium dodecyl sulfate polyacrylamide gel electrophores) SDS-PAGE. Pulsed-field gel electrophoresis (PFGE) and Multilocus sequence typing (MLST) was used to determine the genotypes. Results Susceptibility of antimicrobial agents indicated that all these strains with multiple drug resistance. The resistance rate to piperacillin/tazobactam, ceftriaxone, levofloxacin, ciprofloxacin, gentamicin, tobramycin, cefotetan, ceftazidime, cefepime, aztreonam, imipenem, and meropenem was 100% (18/18). Moreover, the resistance rate of CR-KP isolates to amikacin was 72.2% (13/18), compound sulfamethoxazole was 61.1% (11/18), tigecycline was 0% (0/18). Conjugation study with Escherictda coli J53 resulted in the transfer of significant reduced carbapenem susceptibility from donors (MICs...