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Objective To analyze the resistance genes of carbapenem resistant Enterohacteriaceae (CRE) from Zhongnan Hospital of Wuhan University,so as to provide evidence for CRE infection.Methods WHONET 5.6 software was used to analyze the resistance of carbapenem resistant Enterobacteriaceae isolated.Phenotype screening of 53 CRE strains taken with the modified Hodge test by three drug susceptibility slip to imipenem,meropenem and ertapenem,and analysed resistance gene analysis of 31 CRE strains phenotype screening.Results In 53 CRE strains,34 strains of Klebsiella pneumoniae,ac counting for 64.15 ％,12 strains of Escherichia coli,accounting for 22.64 ％,7 strains of Enterobacter cloacae accounted for 13.21％,and there were 31 strains of Hodge test positive strains,accounting for 58.49％ (31/53).The Hodge test results of three kinds of drug sensitive paper of imipenem,meropenem and ertapenem were consistent.In 31 strains of CRE,29 strains of blaKPC gone were amplified,accounting for 93.55 ％,9 strains of blaNDM gene.accounting for 29.03 ％,contained simaltaneous and two genes of blaKPC and blaNDM were 8 strains,accounting for 25.81 ％,the resistance genes of BlaIMP,blaOXA,and blaVIM were not amplified.Conclusion Resistance to carbapenems was mainly due to the production of KPC and NDM in Enterobacteriaceae of 31 strains.The CRE was detected in the Intensive Care Unit and Respiratory ward for mainly Klebsiella pneumoniae,and the main genotype was KPC.The CRE was detected in the Cadre ward mainly Escherich ia coli,and the drug resistant genotype was mainly a mixed type of KPC and NDM.
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Objective To understand the clone correlation of carbapenem-resistant Acinetobacter baumannii (CRAB)in the environment of intensive care units(ICUs)in Guangzhou City,identify genotypes,and provide basis for prevention and control of healthcare-associated infection(HAI).Methods 39 strains of CRAB isolated from en-vironment of ICUs in 7 hospitals in Guangzhou City were collected,susceptibility to 10 kinds of antimicrobial agents was detected by Kirby-Bauer method,OXA gene of strains was detected by polymerase chain reaction(PCR),clone polymorphism analysis was performed with pulsed-field gel electrophoresis(PFGE)and multilocus sequence typing (MLST).Results Among 39 strains of CRAB,resistance rate to levofloxacin was the lowest(56.4%),resistance rates to other 9 antimicrobial agents were all>90%. PCR results showed that 39 strains(100%)of CRAB all car-ried OXA-51 gene,37(94.9%)carried OXA-23 gene,but OXA-24 and OXA-58 genes were not found. PFGE showed that 38 CRAB strains were divided into 5 clones,group A was the main epidemic clone,MLST analysis showed that the main clone of CRAB was ST195.Conclusion Transmission of CRAB clone carrying OXA-23 gene exists in the ICU environment of Guangzhou City,cleaning and disinfection of ICU environment should be intensi-fied,so as to reduce HAI caused by CRAB.
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Objective To understand the carriage of NDM-1 and other carbapenemases in carbapenem-resistant Acinetobacterbaumannii(CRAB)in Jiangxi area,and provide laboratory basis for the prevention and control of healthcare-associated infection (HAI). Methods Sixty-four strains of CRAB isolated from clinical specimens from 3 tertiary first-class hospitals in Jiangxi area from January 2015 to June 2016 were collected,susceptibility to com-monly used antimicrobial agents were detected with Kirby-Bauer method. Carbapenemases and metalloenzyme in CRAB were screened with modified Hodge test and EDTA-disk synergy test respectively,carbapenems gene was de-tected by polymerase chain reaction (PCR),NDM-1-producing Acinetobacterbaumannii (A. baumannii)were per-formed conjugation test.Results The resistance rates of CRAB to ampicillin/sulbactam,ciprofloxacin,gentamicin, and levofloxacin were up to 95.31% ,98.44% ,90.63% ,and 54.69% respectively. The positive rates of modified Hodge test and EDTA-disk synergy test were 76.56% and 96.88% respectively. PCR amplification result showed that 87.50% (n= 56)of CRAB carried OXA-23 and VIM-1 genes,18.75% (n= 12)carried SIM,3.13% (n= 2)car-ried OXA-24,and 26.56% (n= 17)carried NDM-1 . CRAB carrying NDM-1 gene were all from The First Affilia-ted Hospital of Nanchang University,64.70% (11/17)of which were pandrug-resistant strains. Conjugation test re-sult showed that NDM-1-producing strains could transfer NDM-1 gene to recipient strain Escherichiacoli J53,then acquired resistance to imipenem. Conclusion Antimicrobial resistance rates of clinically isolated CRAB in this area are high,OXA-23 and VIM-1 genes are the main carbapenemase genes,NDM-1 gene positive CRAB is detected, and there may be a clonal spread of NDM-1 gene in hospital,effective measures should be taken as soon as possible to prevent and control the spread of NDM-1 positive CRAB.
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Objective To investigate the carriage and homology of carbapenemase genes of multidrug-resistant Acinetobacterbaumannii (MDRAB)in Wujiang area.Methods A total of 44 non-duplicated MDRAB isolated from patients in 3 general hospitals in Wujiang area from January 2010 to December 2013 were collected. Minimum inhibitory concentrations (MICs)were detected,carbapenemase genes OXA-51,OXA-23,OXA-24,OXA-58, IMP,TEM,SHV,and GES were amplified with polymerase chain reaction(PCR),homology of strains was detec-ted with pulsed-field gel electrophoresis (PFGE).Results 44 MDRAB strains were mainly collected from sputum (93.18% ),mainly distributed in intensive care unit (ICU),department of respiratory diseases,and department of neurosurgery,accounting for 45.45% ,27.27% ,and 13.64% respectively;MDRAB were both sensitive to minocy-cline and polymyxin B,resistance rates to piperacillin,ampicillin/sulbactam,ceftazidime,gentamicin,amikacin, and ciprofloxacin were all 100.00% ,resistance rates to imipenem and meropenem were both 97.73% . 44 MDRAB strains were all detected OXA-51,OXA-23 and TEM genes,12 strains were positive for GES gene,1 strain was positive for OXA-58 and SHV respectively,OXA-24 and IMP genes were not found ;MDRAB were divided into 7 types of G-A,which included 19,3,9,3,1,4,and 5 strains respectively,type A was mainly from two large gen-eral hospitals in Wujiang area (Wujiang First People’s Hospital and Shengze Hospital),type B,D and E strains were not detected in Wujiang First People’s Hospital,type E strain was only 1 isolate and was from Yongding Hos-pital,the other types were sporadically distributed.Conclusion Multidrug resistance of clinically isolated Acineto-bacterbaumannii is serious in Wujiang area,OXA-23 and TEM genes are major causes of multidrug resistance in Acinetobacterbaumannii,the main types are A and C,which present clonal spread.