Antimicrobial resistance, clinical infection characteristics and mcr genes of carbapenem-resistant Enterobacterales
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Department of Laboratory Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China

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    Abstract:

    Objective To analyze the clinical infection characteristics and resistance mechanisms of carbapenem-resistant Enterobacterales (CRE), provide reference for clinical prevention and treatment of CRE infection. Methods Clinically isolated CRE strains and patients information in a tertiary first-class hospital from July 2021 to June 2022 were collected. Antimicrobial resistance genes were detected by polymerase chain reaction. Induced antimicrobial resistance of mcr-9 positive strains was detected by inducing test. Results A total of 167 CRE strains were collected, mainly Klebsiella pneumoniae (38.9%) and Enterobacter cloacae (35.3%). CRE strains demonstrated multiple drug resistance phenotype, with 3 strains (1.8%) exhibiting polymyxin B resistance. Most CRE strains harboured blaNDM (52.1%, n=87) and blaKPC (34.7%, n=58). Patients with CRE infection were divided into NDM group and KPC group according to carbapenemase. Univariate analysis showed that in terms of influencing factors as stay in ICU ≥7 days, endotracheal intubation, and use of carbapenems before infection, KPC group was higher than NDM group, however, curing rate was lower than NDM group (P < 0.05). Multivariate logistic regression analysis showed that gastric intubation, pulmonary diseases and malignant tumor were independent influencing factors for the prognosis of patients with CRE infection of different carbapenemase genes (P < 0.05). Polymyxin B resistant strains all carried mgrB point mutation. 7 (4.2%) CRE strains harboured mcr-9, most of which also harboured blaNDM. MIC values of 4 mcr-9 positive CRE strains after polymyxin B induction were higher than those before induction. Conclusion CRE in this area mainly harbour blaNDM and blaKPC, and a few also harbour mcr-9 and blaNDM, showing multiple drug resistance. Clinical prevention and control should be strengthened to prevent its clinical transmission.

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肖晓,杭修兵,王梦,等.耐碳青霉烯类肠杆菌目细菌耐药性、临床感染特征及mcr基因分析[J].中国感染控制杂志英文版,2023,(1):31-37. DOI:10.12138/j. issn.1671-9638.20233395.
Xiao XIAO, Xiu-bing HANG, Meng WANG, et al. Antimicrobial resistance, clinical infection characteristics and mcr genes of carbapenem-resistant Enterobacterales[J]. Chin J Infect Control, 2023,(1):31-37. DOI:10.12138/j. issn.1671-9638.20233395.

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  • Received:September 21,2022
  • Revised:
  • Adopted:
  • Online: April 28,2024
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