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首页> 外文期刊>Journal of Medical Microbiology: An Official Journal of the Pathological Society of Great Britain and Ireland >Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2 in a Chinese teaching hospital
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Hospital clonal dissemination of Enterobacter aerogenes producing carbapenemase KPC-2 in a Chinese teaching hospital

机译：医院克隆传播肠杆菌天空生产碳酸盐酶KPC-2在中国教学医院

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Carbapenems are first-line agents for the treatment of serious nosocomial infections caused by multidrug-resistant Enterobacteriaceae. However, resistance to carbapenems has increased dramatically among Enterobacteriaceae in our hospital. In this study, we report clonal dissemination caused by carbapenem-resistant Enterobacter aerogenes (CREA). In 2011, CREA was identified from 12 patients admitted to the neurosurgical ward. All 12 clinical isolates were non-susceptible to cefotaxime, ceftazidime, cefoxitin, ertapenem, imipenem or meropenem. All isolates carried the gene encoding Klebsiella pneumoniae carbapenemase-2 (KPC-2), except for the isolate E4. However, a remarkably lower expression level of the porin OmpF was detected in the non-KPC-2-producing isolate E4 on SDS-PAGE compared with the carbapenem-susceptible isolate. Epidemiological and molecular investigations showed that a single E. aerogenes strain (PFGE type A), including seven KPC-2-producing clinical isolates, was primarily responsible for the first isolation and subsequent dissemination. In a case-control study, we identified risk factors for infection/colonization with CREA. Mechanical ventilation, the changing of sickbeds and previous use of broad-spectrum antibiotics were identified as potential risk factors. Our findings suggest that further studies should focus on judicious use of available antibiotics, implementation of active antibiotic resistance surveillance and strict implementation of infection-control measures to avoid the rapid spread or clonal dissemination caused by carbapenem-resistant Enterobacteriaceae in healthcare facilities.
机译：Carbapenems是一种用于治疗由多药抗生素造成的严重医院感染的一线剂。然而，我们医院的肠杆菌膜中对肠蛋白的抗性急剧增加。在这项研究中，我们报告了耐肠道肠杆菌肠杆菌（Crea）引起的克隆传播。 2011年，CREA已从12名患者中鉴定到Neurosurgical病房。所有12个临床分离物都不易于Cefotaxime，头孢他啶，CeFoxitin，ErtapeNem，Imipenem或Meropenem。除了分离物E4之外，所有分离物都携带编码Klebsiella肺炎蛋白酶-2（KPC-2）的基因。然而，与肉豆蔻溶解的分离物相比，在SDS-PAGE上的非KPC-2产生的分离物E4中检测到孔隙OMPF的显着降低的表达水平。流行病学和分子研究表明，单一的E. Aemae Aigogenes菌株（PFGE型A），包括七种KPC-2产生的临床分离株，主要负责第一分离和随后的散发。在案例对照研究中，我们确定了与Crea的感染/定植的危险因素。机械通风，生病的变化以及以前使用广谱抗生素被认为是潜在的危险因素。我们的研究结果表明，进一步的研究应专注于可明智使用可用的抗生素，实施活性抗生素抵抗监测和严格实施感染控制措施，以避免由耐医疗机构中的耐肠道肠杆菌的快速扩散或克隆传播。

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