PDF(Pubmed)
Abstract：
UNASSIGNED: Bacterial resistance is a major threat to public health worldwide. To gain an understanding of the clinical infection distribution, drug resistance information, and genotype of CRE in Dongguan, China, as well as the resistance of relevant genotypes to CAZ-AVI, this research aims to improve drug resistance monitoring information in Dongguan and provide a reliable basis for the clinical control and treatment of CRE infection.
UNASSIGNED: VITEK-2 Compact automatic analyzer was utilized to identify 516 strains of CRE collected from January 2017 to June 2023. To determine drug sensitivity, the K-B method, E-test, and MIC methods were used. From June 2022 to June 2023, 80 CRE strains were selected, and GeneXpert Carba-R was used to detect and identify the genotype of the carbapenemase present in the collected CRE strains. An in-depth analysis was conducted on the CAZ-AVI in vitro drug sensitivity activity of various genotypes of CRE, and the results were statistically evaluated using SPSS 23.0 and WHONET 5.6 software.
UNASSIGNED: This study identified 516 CRE strains, with the majority (70.16%) being K.pneumoniae, followed by E.coli (18.99%). Respiratory specimens had highest detection rate with 53.77% identified, whereas urine specimens had the second highest detection rate with 17.99%. From June 2022 to June 2023, 95% of the strains tested using the CRE GeneXpert Carba-R assay possessed carbapenemase genes, of which 32.5% were blaNDM strains and 61.25% blaKPC strains. The results showed that CRE strains containing blaKPC had a significantly higher rate of resistance to amikacin, cefepime, and aztreonam than those harboring blaNDM.
UNASSIGNED: The CRE strains isolated from Dongguan region demonstrated a high resistance rate to various antibiotics used in clinical practice but a low resistance rate to tigecycline. These strains produce Class A serine carbapenemases and Class B metals β-lactamases, with the majority of them carrying blaNDM and blaKPC. Notably, CRE strains with blaKPC and blaNDM had significantly lower resistance rates to tigecycline. CAZ-AVI showed a good sensitivity rate with no resistance to CRE strains carrying blaKPC. Therefore, CAZ-AVI and tigecycline should be used as a guide for rational use of antibiotics in clinical practice to effectively treat CRE.
UNASSIGNED: VITEK-2 Compact automatic analyzer was utilized to identify 516 strains of CRE collected from January 2017 to June 2023. To determine drug sensitivity, the K-B method, E-test, and MIC methods were used. From June 2022 to June 2023, 80 CRE strains were selected, and GeneXpert Carba-R was used to detect and identify the genotype of the carbapenemase present in the collected CRE strains. An in-depth analysis was conducted on the CAZ-AVI in vitro drug sensitivity activity of various genotypes of CRE, and the results were statistically evaluated using SPSS 23.0 and WHONET 5.6 software.
UNASSIGNED: This study identified 516 CRE strains, with the majority (70.16%) being K.pneumoniae, followed by E.coli (18.99%). Respiratory specimens had highest detection rate with 53.77% identified, whereas urine specimens had the second highest detection rate with 17.99%. From June 2022 to June 2023, 95% of the strains tested using the CRE GeneXpert Carba-R assay possessed carbapenemase genes, of which 32.5% were blaNDM strains and 61.25% blaKPC strains. The results showed that CRE strains containing blaKPC had a significantly higher rate of resistance to amikacin, cefepime, and aztreonam than those harboring blaNDM.
UNASSIGNED: The CRE strains isolated from Dongguan region demonstrated a high resistance rate to various antibiotics used in clinical practice but a low resistance rate to tigecycline. These strains produce Class A serine carbapenemases and Class B metals β-lactamases, with the majority of them carrying blaNDM and blaKPC. Notably, CRE strains with blaKPC and blaNDM had significantly lower resistance rates to tigecycline. CAZ-AVI showed a good sensitivity rate with no resistance to CRE strains carrying blaKPC. Therefore, CAZ-AVI and tigecycline should be used as a guide for rational use of antibiotics in clinical practice to effectively treat CRE.
摘要：
细菌耐药性是全球公共卫生的主要威胁。为了了解临床感染分布，耐药性信息，东莞CRE的基因型，中国,以及相关基因型对CAZ-AVI的抗性，本研究旨在完善东莞市CRE感染的耐药监测信息，为临床控制和治疗CRE感染提供可靠依据。
■VITEK-2紧凑型自动分析仪用于鉴定从2017年1月至2023年6月收集的516株CRE。为了确定药物敏感性，K-B方法，电子测试,使用MIC方法。2022年6月至2023年6月，筛选出80株CRE菌株，和GeneXpertCarba-R用于检测和鉴定存在于收集的CRE菌株中的碳青霉烯酶的基因型。对不同基因型CRE的CAZ-AVI的体外药敏活性进行了深入分析,结果采用SPSS23.0和WHONET5.6软件进行统计学评价。
■这项研究确定了516个CRE菌株，大多数(70.16%)是肺炎克雷伯菌，其次是大肠杆菌（18.99%）。呼吸道标本检出率最高，为53.77%，而尿液标本的检出率第二高，为17.99%。从2022年6月到2023年6月，使用CREGeneXpertCarba-R测定测试的菌株中有95％具有碳青霉烯酶基因，其中blaNDM菌株占32.5%，blaKPC菌株占61.25%。结果表明，含blaKPC的CRE菌株对阿米卡星的耐药率明显较高，头孢吡肟,和氨曲南比那些藏有blaNDM的人。
■从东莞地区分离的CRE菌株对临床实践中使用的各种抗生素具有较高的耐药率，但对替加环素的耐药率较低。这些菌株产生A类丝氨酸碳青霉烯酶和B类金属β-内酰胺酶，其中大多数携带blaNDM和blaKPC。值得注意的是,具有blaKPC和blaNDM的CRE菌株对替加环素的耐药率显着降低。CAZ-AVI对携带blaKPC的CRE菌株具有良好的敏感率，没有耐药性。因此,CAZ-AVI和替加环素应作为临床合理使用抗生素的指导，以有效治疗CRE。
■VITEK-2紧凑型自动分析仪用于鉴定从2017年1月至2023年6月收集的516株CRE。为了确定药物敏感性，K-B方法，电子测试,使用MIC方法。2022年6月至2023年6月，筛选出80株CRE菌株，和GeneXpertCarba-R用于检测和鉴定存在于收集的CRE菌株中的碳青霉烯酶的基因型。对不同基因型CRE的CAZ-AVI的体外药敏活性进行了深入分析,结果采用SPSS23.0和WHONET5.6软件进行统计学评价。
■这项研究确定了516个CRE菌株，大多数(70.16%)是肺炎克雷伯菌，其次是大肠杆菌（18.99%）。呼吸道标本检出率最高，为53.77%，而尿液标本的检出率第二高，为17.99%。从2022年6月到2023年6月，使用CREGeneXpertCarba-R测定测试的菌株中有95％具有碳青霉烯酶基因，其中blaNDM菌株占32.5%，blaKPC菌株占61.25%。结果表明，含blaKPC的CRE菌株对阿米卡星的耐药率明显较高，头孢吡肟,和氨曲南比那些藏有blaNDM的人。
■从东莞地区分离的CRE菌株对临床实践中使用的各种抗生素具有较高的耐药率，但对替加环素的耐药率较低。这些菌株产生A类丝氨酸碳青霉烯酶和B类金属β-内酰胺酶，其中大多数携带blaNDM和blaKPC。值得注意的是,具有blaKPC和blaNDM的CRE菌株对替加环素的耐药率显着降低。CAZ-AVI对携带blaKPC的CRE菌株具有良好的敏感率，没有耐药性。因此,CAZ-AVI和替加环素应作为临床合理使用抗生素的指导，以有效治疗CRE。
