blaOXA-48样、blaNDM、blaKPC、blaIMP-1、blaVIM基因在土耳其东南部耐碳青霉烯大肠杆菌和肺炎克雷伯菌株中的传播:首次报道肺炎克雷伯菌共产blaOXA-48样、blaVIM和blaIMP-1基因

Q3 Medicine

Reviews in Medical Microbiology Pub Date : 2021-06-07 DOI:10.1097/MRM.0000000000000287

Özge Alkan Bilik, M. Bayraktar, Nida Özcan, K. Gül, N. Akpolat

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引用次数: 0

摘要

碳青霉烯耐药肠杆菌(CRE)引起严重和危及生命的感染，治疗方案有限。碳青霉烯耐药的最常见原因是碳青霉烯酶。我们的目的是确定最普遍的碳青霉烯酶基因;土耳其东南地区肺炎克雷伯菌和大肠杆菌株中blaNDM、blaKPC、blaIMP-1、blaVIM、blaxa -48样基因方法:共分离89株，其中肺炎克雷伯菌74株，大肠杆菌15株。经BD Phoenix自动化系统和Kirby Bauer盘片扩散试验鉴定，分离菌株对碳青霉烯具有耐药性。药敏试验采用BD Phoenix自动检测系统。采用组合圆盘法(CDM)作为碳青霉烯酶的表型检测方法。采用Xpert CARBA-R(美国造父变星)多重PCR商用系统检测blaNDM、blaKPC、blaIMP-1、blaVIM和blaoxa -48样基因的存在。结果:凤凰对阿米卡星、氨曲南、头孢吡肟、头孢他啶、环丙沙星、左氧氟沙星、莫西沙星、甲氧苄啶磺胺甲恶唑和哌拉西林-他唑巴坦的耐药率分别为48.3、97.8、80.9、96.6、93.3、96.6、97.8、69.7和97.8%。65例(73%)检测到blaoxa -48样基因;blaNDM基因4例(4.5%);blaoxa -48 like和blaNDM合产6个(6.7%);在1株(1.2%)分离物中联合产生blaoxa -48样、blaVIM和blaIMP-1基因。13株(14.6%)分离株未检出blaoxa -48样、blaNDM、blaVIM、blaIMP-1、blaKPC基因。CDM的敏感性和特异性分别为80%和85%。结论:本地区blaoxa -48样基因检测频率最高。据我们所知，这是首次报道肺炎克雷伯菌共同产生blaoxa -48样、blaVIM和blaIMP-1基因。这些基因的共存令人担忧，并导致感染控制和治疗问题。有效的感染控制措施对于防止抗生素耐药性的蔓延至关重要。

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Dissemination of blaOXA-48 like, blaNDM, blaKPC, blaIMP-1, blaVIM genes among carbapenem-resistant Escherichia coli and Klebsiella pneumoniae strains in Southeastern Turkey: first report of Klebsiella pneumoniae co-producing blaOXA-48-like, blaVIM and blaIMP-1 genes

Introduction: Carbapenem-resistant Enterobacterales (CRE) cause serious and life-threatening infections with limited treatment options. The most common causes of carbapenem resistance are carbapenemases. We aimed to determine the most prevalent carbapenemase genes; blaNDM, blaKPC, blaIMP-1, blaVIM, blaOXA-48 like genes among Klebsiella pneumoniae and Escherichia coli strains in the southeast region of Turkey. Methods: Eighty-nine isolates (74 K. pneumoniae, 15 E. coli) were included in the study. The isolates were found as carbapenem-resistant by BD Phoenix automated system and Kirby Bauer disk diffusion test. Antibiotic susceptibility testing was performed by BD Phoenix automated system. Combination disc method (CDM) was also carried out as phenotypic method of carbapenemase detection. The presence of blaNDM, blaKPC, blaIMP-1, blaVIM and blaOXA-48-like genes were investigated by Xpert CARBA-R (Cepheid, USA) multiplex PCR commercial system. Results: Antibiotic resistance rates by Phoenix were 48.3 97.8, 80.9, 96.6, 93.3, 96.6, 97.8, 69.7 and 97.8% for amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, levofloxacin, moxifloxacin, trimethoprim sulfamethoxazole and piperacillin-tazobactam, respectively. The blaOXA-48-like gene was detected in 65 (73%); blaNDM gene in 4 (4.5%); co-production of blaOXA-48-like and blaNDM in 6 (6.7%); co-production of blaOXA-48-like, blaVIM and blaIMP-1 genes in 1(1.2%) isolate. None of the blaOXA-48-like, blaNDM, blaVIM, blaIMP-1, blaKPC genes were detected in 13 (14.6%) of the isolates. The sensitivity and specificity of CDM were calculated as 80 and 85% respectively. Conclusion: We detected blaOXA-48-like gene most frequently in our region. To our knowledge, this is the first report of K. pneumoniae-co-producing blaOXA-48-like, blaVIM and blaIMP-1 genes. The coexistence of these genes is alarming and causes both infection control and treatment problems. Effective infection control measures are essential to prevent the spread of antibiotic resistance.

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来源期刊

Reviews in Medical Microbiology 生物-微生物学

CiteScore

1.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Reviews in Medical Microbiology is a quarterly review journal which provides a balanced coverage of the whole field of medical microbiology. The Journal publishes state-of-the art reviews, mini-reviews, case presentations and original research from on-going research of the latest developments and techniques in medical microbiology, virology, mycology, parasitology, clinical microbiology, and hospital infection. In addition, PhD-Review - a platform for young researchers, and biographical Bio-Sketch articles are also considered. Reviews are concise, authoritative, and readable synthesis of the latest information on its subject, and references are limited to the fifty key sources for full reviews and twenty for mini-reviews. Reviews in Medical Microbiology is the perfect way for both qualified and trainee microbiologists, and researchers and clinicians with an interest in microbiology, to stay fully informed of the latest developments in medical microbiology. The journal is a valuable resource for educational and teaching purposes.