Journal of Diagnostics Concepts & Practice >

2019 , Vol. 18 >Issue 06: 655 - 661

DOI: https://doi.org/10.16150/j.1671-2870.2019.06.010

Original articles

Study on carbapenem resistance genes within isolated carbapenem-resistant Escherichia coli strains

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  • Department of Clinical Microbiology Laboratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Received date: 2019-07-25

  Online published: 2019-12-25

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Abstract

Objective: To study the carbapenem resistance genes of clinically isolated carbapenem-resistant Escherichia coli strains. Methods: Non-repetitive carbapenem-resistant Escherichia coli strains isolated from clinical specimens of inpatients in our hospital from March 2009 to October 2017 were collected. The strains were firstly confirmed by MicroflexTM MALDI-TOF MS, then drug sensitivity of isolates was tested by K-B method combined with Vitek-2 Compact Automatic Microbiological Analyzer. Rapid screening of carbapenemase-producing Escherichia coli was performed using the modified carbapenem inactivation method (mCIM). Commonly seen carbapenemase was detected by regular PCR and DNA sequencing. The clinical data of patients were analyzed. Result: From March 2009 to December 2017, a total of 84 non-repetitive carbapenem-resistant Escherichia coli strains were isolated. Drug resistance test showed that carbapenem-resistant Escherichia coli had a very high resistance rate (up to 80%-100%) for most of the commonly used drugs except amikacin, whose drug resistance rate was less than 50%. A total of 71 carbapenemase-producing strains were identified by mCIM. The PCR and DNA sequencing results for drug resistance genes showed that there were 65 strains carrying blaNDM, with blaNDM-5 (64.6%, 42/65) and blaNDM-1(24.6%, 16/65) as the main types, and of them 2 strains carried both blaNDM-1 and blaMCR-1; 6s trains carriedblakpc-2; while no blaGES, blaIMP, blaVIM, blaOXA were detected. Altogether 17 types of clinical specimens and 23 departments were concerned, urine samples accounted for 30.95% (26/84) and sputum samples accounted for 21.43% (18/84). Carbapenemase-producing strains were mainly isolated from pediatric patients (66.7%, 56/84). Most of the strains isolated from children and infants were enzyme-producing (96.4%, 54/56), of which blaNDM-5 accounted for 63.0%(34/54). Most of the strains isolated from elderly patients were non-enzyme-producing (62.5%, 10/16). Besides, 54% (45/84) of these patients underwent surgery, while 33% (28/84) of them were treated with indwelling deep vein catheter and invasive medical procedures. Conclusions: The carbapenem-resistant Escherichia coli strains isolated from patients in our hospital mostly are multi-drug resistant. NDM and KPC are the main carbapenemase, and NDM-5 is the major type with a detection rate as high as 50%(42/84). The isolated rate of carbapenem-resistant Escherichia coli in pediatric wards is high, especially in critical care wards.

Key words： Escherichia coli; Carbapenem; Resistance genes

Cite this article

DIAO Wenjing, HUANGFU Yuchan, ZHU Weinan, LIU Jingxian, LIU Ying, SHEN Lisong . Study on carbapenem resistance genes within isolated carbapenem-resistant Escherichia coli strains[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(06) : 655 -661 . DOI: 10.16150/j.1671-2870.2019.06.010

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