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.
■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。