Journal of Diagnostics Concepts & Practice >
Study on carbapenem resistance genes within isolated carbapenem-resistant Escherichia coli strains
Received date: 2019-07-25
Online published: 2019-12-25
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
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
[1] | Zong Z, Fenn S, Connor C, et al. Complete genomic characterization of two Escherichia coli lineages responsible for a cluster of carbapenem-resistant infections in a Chinese hospital[J]. J Antimicrob Chemother, 2018, 73(9):2340-2346. |
[2] | Tfifha M, Ferjani A, Mallouli M, et al. Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia[J]. Libyan J Med, 2018, 13(1):1419047. |
[3] | Guh AY, Bulens SN, Mu Y, et al. Epidemiology of Carbapenem-Resistant Enterobacteriaceae in 7 US Communities, 2012-2013[J]. JAMA, 2015, 314(14):1479-1487. |
[4] | Ortega A, Sáez D, Bautista V, et al. Carbapenemase-producing Escherichia coli is becoming more prevalent in Spain mainly because of the polyclonal dissemination of OXA-48[J]. J Antimicrob Chemother, 2016, 71(8):2131-2138. |
[5] | 胡付品. 2005-2014年CHINET中国细菌耐药性监测网5种重要临床分离菌的耐药性变迁[J]. 2017, 17(1):93-99. |
[6] | Potter RF, D'Souza AW, Dantas G. The rapid spread of carbapenem-resistant Enterobacteriaceae[J]. Drug Resist Updat, 2016, 29:30-46. |
[7] | Khan AU, Maryam L, Zarrilli R. Structure, genetics and worldwide spread of New Delhi metallo-β-lactamase (NDM): a threat to public health[J]. BMC Microbiol, 2017, 17(1):101. |
[8] | Zhang R, Chan EW, Zhou H, et al. Prevalence and genetic characteristics of carbapenem-resistant Enterobacteriaceae strains in China[J]. Lancet Infect Dis, 2017, 17(3):256-257. |
[9] | Liang WJ, Liu HY, Duan GC, et al. Emergence and mechanism of carbapenem-resistant Escherichia coli in Henan, China, 2014[J]. J Infect Public Health, 2018, 11(3):347-351. |
[10] | Zhang F, Zhu D, Xie L, et al. Molecular epidemiology of carbapenemase-producing Escherichia coli and the prevalence of ST131 subclone H30 in Shanghai, China[J]. Eur J Clin Microbiol Infect Dis, 2015, 34(6):1263-1269. |
[11] | Sjövall F, Alobaid AS, Wallis SC, et al. Maximally effective dosing regimens of meropenem in patients with septic shock[J]. J Antimicrob Chemother, 2018, 73(1):191-198. |
[12] | Performance standards for antimicrobial susceptibility testin[S]. Wayne: CLSI, 2018. |
[13] | Weiner LM, Webb AK, Limbago B, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: Summary of data reported to the national Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014[J]. Infect Control Hosp Epidemiol, 2016, 37(11):1288-1301. |
[14] | Ku LC, Boggess KA, Cohen-Wolkowiez M. Bacterial meningitis in infants[J]. Clin Perinatol, 2015, 42(1):29-45,vii-viii. |
[15] | Trepanier P, Mallard K, Meunier D, et al. Carbapenemase-producing Enterobacteriaceae in the UK: a national study (EuSCAPE-UK) on prevalence, incidence, laboratory detection methods and infection control measures[J]. J Antimicrob Chemother, 2017, 72(2):596-603. |
[16] | Gajamer VR, Bhattacharjee A, Paul D, et al. Escherichia coli encoding blaNDM-5 associated with community-acquired urinary tract infections with unusual MIC creep-like phenomenon against imipenem[J]. J Glob Antimicrob Resist, 2018, 14:228-232. |
[17] | Giufrè M, Errico G, Accogli M, et al. Emergence of NDM-5-producing Escherichia coli sequence type 167 clone in Italy[J]. Int J Antimicrob Agents, 2018, 52(1):76-81. |
[18] | Munoz-Price LS, Poirel L, Bonomo RA, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases[J]. Lancet Infect Dis, 2013, 13(9):785-796. |
[19] | Zhao D, Zhou Z, Hua X, et al. Coexistence of mcr-1, blaKPC-2 and two copies of fosA3 in a clinical Escherichia coli strain isolated from urine[J]. Infect Genet Evol, 2018, 60:77-79. |
[20] | Guo Y, Hu FP, Zhu DM, et al. Antimicrobial resistance changes of carbapenem-resistant Enterobacteriaceae strains isolated from children[J]. Zhonghua Er Ke Za Zhi, 2018, 56(12):907-914. |
[21] | Zhou Y, Zhu X, Hou H, et al. Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study[J]. BMC Infect Dis, 2018, 18(1):63. |
[22] | Zhou Y, Liu S, Wang T, et al. Pterostilbene, a potential MCR-1 inhibitor that enhances the efficacy of polymyxin B[J]. Antimicrob Agents Chemother, 2018, 62(4),pii:e02146-17. |
[23] | Zheng B, Lv T, Xu H, et al. Discovery and characterisation of an escherichia coli ST206 strain producing NDM-5 and MCR-1 from a patient with acute diarrhoea in China[J]. Int J Antimicrob Agents, 2018, 51(2):273-275. |
[24] | Wang R, Liu Y, Zhang Q, et al. The prevalence of coli-stin resistance in Escherichia coli and Klebsiella pneumoniae isolated from food animals in China: coexistence of mcr-1 and blaNDM with low fitness cost[J]. Int J Antimicrob Agents, 2018, 51(5):739-744. |
[25] | Xie M, Li R, Liu Z, et al. Recombination of plasmids in a carbapenem-resistant NDM-5-producing clinical Escherichia coli isolate[J]. J Antimicrob Chemother, 2018, 73(5):1230-1234. |
[26] | Smith Moland E, Hanson ND, Herrera VL et al. Plasmid-mediated, carbapenem-hydrolysing beta-lactamase, KPC-2, in Klebsiella pneumoniae isolates[J]. J Antimicrob Chemother, 2003, 51(3):711-714. |
[27] | Çetinkol Y, Sandalli C, Çalgin MK, et al. High prevalence of NDM metallo-β-lactamase among ESBL-produ-cing Escherichia coli Çsolates[J]. Acta Microbiol Immunol Hung, 2017, 64(2):131-141. |
[28] | Hafza N, Challita C, Dandachi I, et al. Competition assays between ESBL-producing E. coli and K. pneumoniae isolates collected from Lebanese elderly: An additional cost on fitness[J]. J Infect Public Health, 2018, 11(3):393-397. |
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