Journals / Journal of Microbiology and Infectious Diseases / 2014 / Cilt: 4 - Sayı: 04

Molecular characteristics of carbapenem-resistant Enterobacteriaceae isolates from a Chinese Tertiary Hospital

Pages
145–151
Publication Date
2014-12-01
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

To prevent both CRE transmission and infections has become significantly urgent public health objectives.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The aim of this study was to investigate the molecular characteristics of carbapenem-resistant Enterobacteria­ceae (CRE) isolates from a teaching hospital in Guangdong, China, during the period between January 2008 and December 2011.
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Key Findings & Data:Methods: A total of 28 (0.9%) CRE isolates were collected among 3286 isolates.
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Conclusion & Impact:To prevent both CRE transmission and infections has become significantly urgent public health objectives.
🔬Design:Research Article
📍Scope:2008 Verileri
⚙️Variables:Moleküler özellikler · karbapenem dirençli · Enterobacteriaceae

Abstract

Objective: The aim of this study was to investigate the molecular characteristics of carbapenem-resistant Enterobacteria­ceae (CRE) isolates from a teaching hospital in Guangdong, China, during the period between January 2008 and December 2011. Methods: A total of 28 (0.9%) CRE isolates were collected among 3286 isolates. Antimicrobial susceptibility testing, Modified Hodge Test (MHT) and genotyping by pulsed-field gel electrophoresis were performed. Extended-spectrum β-lactamase (ESBL) and carbapenemase genes were detected using gene amplification and sequencing. Outer membrane porin (OMP) genes (OmpK35/OmpK36 for K. pneumoniae, OmpC/OmpF for E. cloacae were examined. Results: Seven (25.0%) isolates of the 28 carbapenem resistant Enterobacteriaceae had a positive MHT. PCR and sequenc­ing analysis revealed that 19 of the 28 isolates were molecularly confirmed to harbor ESBLs (15 isolates, 53.6%), AmpC (6 isolates, 21.4%), or IMP-4 (five isolates, 17.9%), and nine (32.1%) isolates of the 28 isolates possessed at least two different classes of β-lactamases. Specially, five (71.4%) of seven MHT-positive CRE isolates is due to the production of the carbapen­emase-encoding gene IMP-4. Almost all of the CRE isolates in the present study loss gene expressions of OmpK35 and/or OmpK36 in K. pneumoniae, OmpC and/or OmpF in E. cloacae, except for one K. pneumoniae. PFGE analysis demonstrated genomic variability. Conclusion: Carbapenem resistance in Enterobacteriaceae is due to the combined effect of β- lactamases with porin im­permeability caused by loss of OMPs observed in these organisms. To prevent both CRE transmission and infections has become significantly urgent public health objectives.

Özet

ET Amaç: Bu çalışmada Çin’in Guangdong bölgesinde bulunan bir eğitim hastanesinde, Ocak 2008 ile Aralık 2011 tarihleri arasında dönemde izole edilen karbapenem dirençli Enterobacteriaceae (CRE), kökenlerinin moleküler özelliklerini incelemesi amaçlanmıştır.Yöntemler: Çalışma döneminde 3286 suştan toplam 28 (% 0,9) CRE izolatı ayrıştırıldı ve çalışmaya alındı. Antimikrobiyal duyarlılık testleri, Modifiye Hodge (MHT) testi ve genotip incelenmesinde Pulsed-field jel elektroforez kullanıldı. Genişletilmiş spektrumlu β-laktamaz (GSBL) ve karbapenemaz genlerinin varlığı, gen amplifikasyonu ve dizi analizi kullanılarak tespit edildi. Bakterilerin Dış zar porini (OMP) genleri (OmpK35 / OmpK36 K. pneumoniae, E. cloacae için OMPC / OmpF) incelendi.Bulgular: MHT ile 28 kökenin yedisi (% 25,0) dirençli Enterobacteriaceae olarak tanımlandı. PCR ve dizi analizi gibi moleküler yöntemlerle kökenlerden 15’inin (% 53,6) GSBL pozitif olduğu, altısının AmpC (% 21,4), beşinin IMP-4 (% 17,9) ve dokuzunun en az iki farklı sınıf dirence sahip olduğu görülmüştür. Özel olarak, yedi MHT pozitif kökenin beşinin (% 71,4) karbapenemaz kodlayan genlerinin IMP-4 üretimine bağlı iken PFGE analizinde bir K. pneumoniae dışında hemen hemen tüm CRE kökenlerinin, OMPC ve / veya ompF içinde OmpK35 ve / veya OmpK36 kaybı gen ifade kaybı gözlendi. PFGE analizi genomik değişkenlik gösterdi.Sonuç: Enterobacteriaceae karbapenem direnci bu organizmalarda gözlenen OMP’lerin kayb sonucu oluşan porin’e değişimi ve β-laktamazların kombine etkisi nedeniyle oluşmaktadır. CRE yayılımı ve enfeksiyonlar hem anlamlı acil halk sağlığı hedefleri haline gelmiştir önlemek için

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Cite This Article

LİAO, K., CHEN, Y., HUANG, H., GUO, P., CHEN, D., LİU, M., ZENG, Y. (2014). Molecular characteristics of carbapenem-resistant Enterobacteriaceae isolates from a Chinese Tertiary Hospital. Journal of Microbiology and Infectious Diseases, Cilt: 4 - Sayı: 04, 145–151. https://ajindex.com/articles/48282

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References (13)

  1. Brink AJ, Feldman C, Grolman DC, et al. Appropriate use of the carbapenems. S Afr Med J 2004; 94:857-861.
  2. Rhomberg P R, Jones R N. Summary trends for the Me- ropenem Yearly Susceptibility Test Information Collection Program: a 10-year experience in the United States (1999- 2008). Diagn Microbiol Infect Dis 2009; 65:414-426.
  3. Hidron AI, Edwards JR, Patel J, et al. NHSN annual update: antimicrobial-resistant pathogens associated with health- care-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol 2008; 29:996-1011.
  4. Livermore DM, Woodford N. The beta-lactamase threat in En- terobacteriaceae, Pseudomonas and Acinetobacter. Trends Microbiol 2006; 14:413-420.
  5. Nordmann P, Naas T, Poirel L. Global spread of Carbapene- mase-producing Enterobacteriaceae. Emerg Infect Dis 2011; 17:1791-1798.
  6. Doumith M, Ellington M J, Livermore D M, et al. Molecular mechanisms disrupting porin expression in ertapenem-resis- tant Klebsiella and Enterobacter spp. clinical isolates from the UK. J Antimicrob Chemother 2009; 63:659-667.
  7. Kim S Y, Park Y J, Yu J K, et al. Prevalence and mechanisms of decreased susceptibility to carbapenems in Klebsiella pneu- moniae isolates. Diagn Microbiol Infect Dis 2007; 57:85-91.
  8. Wang X D, Cai J C, Zhou H W, et al. Reduced susceptibility to carbapenems in Klebsiella pneumoniae clinical isolates associated with plasmid-mediated beta-lactamase produc- tion and OmpK36 porin deficiency. J Med Microbiol 2009; 58:1196-1202.
  9. Cai J C, Zhou H W, Zhang R, et al. Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem- hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital. Antimicrob Agents Chemother 2008; 52:2014-2018.
  10. Yu F, Ying Q, Chen C, et al. Outbreak of pulmonary infec- tion caused by Klebsiella pneumoniae isolates harbouring blaIMP-4 and blaDHA-1 in a neonatal intensive care unit in China. J Med Microbiol 2012; 61:984-989.
  11. Wei Z, Yu T, Qi Y, et al. Coexistence of plasmid-mediated KPC-2 and IMP-4 carbapenemases in isolates of Kleb- siella pneumoniae from China. J Antimicrob Chemother 2011;66:2670-2671.
  12. Yan J J, Ko W C, Wu H M, et al. Complexity of Klebsiella pneumoniae isolates resistant to both cephamycins and extended-spectrum cephalosporins at a teaching hospital in Taiwan. J Clin Microbiol 2004;42:5337-5340.
  13. Yigit H, Quee