Antimicrobial resistance mechanism of Enterobacter cloacae to carbapenems
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1.Department of Laboratory Medicine, Jinan City People's Hospital, Jinan 271100, China;2.Department of Laboratory Medicine, People's Hospital of West Coast New District of Qingdao Huangdao District, Qingdao 266500, China;3.Department of Laboratory Medicine, Taian City Central Hospital, Taian 271000, China

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    Abstract:

    Objective To study the molecular epidemiological characteristics of carbapenem-resistant Enterobacter cloacae (CREC) and mechanism of carbapenem resistance, provide basis for clinical empirical antimicrobial use as well as prevention and control of healthcare-associated infection. Methods CREC isolated from a hospital between April and September 2019 were identified and performed antimicrobial susceptibility analysis, carbapenemase was screened by modified carbapenem inactivation method (mCIM) and EDTA-modified carbapenem inactivation method (eCIM), carbapenem-resistant genes were detected by polymerase chain reaction (PCR), molecular epidemiological characteristics were analyzed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Results Among 8 strains of CREC, 5 were from intensive care unit (ICU) and were highly resistant to cephalosporins and enzyme inhibitors commonly used in clinical practice. All strains carried metallo-β-lactamases, 7 strains carried blaNDM-1 and 1 strain carried blaIPM-4. MLST molecular typing and PFGE homology analysis showed 6 ST sequence types and 6 clone groups. ST596 (3 strains), ST121 (1 strain), ST993 (1 strain), ST91 (1 strain), ST794 (1 strain) B and ST88 (1 strain) belonged to groups A, C, F, E, B and D respectively. Conclusion CREC in this hospital mainly comes from ICU, producing of metalloenzyme blaNDM-1 β-lactamase is the main resistance mechanism. ST596 group A Enterobacter cloacae has local epidemic in ICU for a short time, prevention and control measures of HAI should be strengthened to curb the outbreak.

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刘丽娟,王学,姜梅杰,等.阴沟肠杆菌对碳青霉烯类药物的耐药机制[J].中国感染控制杂志英文版,2021,(8):681-687. DOI:10.12138/j. issn.1671-9638.20218152.
Li-juan LIU, Xue WANG, Mei-jie JIANG, et al. Antimicrobial resistance mechanism of Enterobacter cloacae to carbapenems[J]. Chin J Infect Control, 2021,(8):681-687. DOI:10.12138/j. issn.1671-9638.20218152.

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  • Received:October 19,2020
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  • Online: September 06,2021
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