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Abstract：
OBJECTIVE: In the recent years, multidrug resistant (MDR) neonatal septicemia-causing Enterobacterales has been dramatically increased due to the extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes. This study aimed to assess the antibiotic resistance pattern, prevalence of ESBLs/AmpC beta-lactamase genes, and Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) fingerprints in Enterobacterales isolated from neonatal sepsis.
RESULTS: In total, 59 Enterobacterales isolates including 41 (69.5%) Enterobacter species, 15 (25.4%) Klebsiella pneumoniae and 3 (5.1%) Escherichia coli were isolated respectively. Resistance to ceftazidime and cefotaxime was seen in all of isolates. Furthermore, all of them were multidrug-resistant (resistant to three different antibiotic categories). The phenotypic tests showed that 100% of isolates were ESBL-positive. Moreover, AmpC production was observed in 84.7% (n = 50/59) of isolates. Among 59 ESBL-positive isolates, the highest percentage belonged to blaCTX-M-15 gene (66.1%) followed by blaCTX-M (45.8%), blaCTX-M-14 (30.5%), blaSHV (28.8%), and blaTEM (13.6%). The frequency of blaDHA, blaEBC, blaMOX and blaCIT genes were 24%, 24%, 4%, and 2% respectively. ERIC-PCR analysis revealed that Enterobacterales isolates were genetically diverse. The remarkable prevalence of MDR Enterobacterales isolates carrying ESBL and AmpC beta-lactamase genes emphasizes that efficient surveillance measures are essential to avoid the more expansion of drug resistance amongst isolates.
RESULTS: In total, 59 Enterobacterales isolates including 41 (69.5%) Enterobacter species, 15 (25.4%) Klebsiella pneumoniae and 3 (5.1%) Escherichia coli were isolated respectively. Resistance to ceftazidime and cefotaxime was seen in all of isolates. Furthermore, all of them were multidrug-resistant (resistant to three different antibiotic categories). The phenotypic tests showed that 100% of isolates were ESBL-positive. Moreover, AmpC production was observed in 84.7% (n = 50/59) of isolates. Among 59 ESBL-positive isolates, the highest percentage belonged to blaCTX-M-15 gene (66.1%) followed by blaCTX-M (45.8%), blaCTX-M-14 (30.5%), blaSHV (28.8%), and blaTEM (13.6%). The frequency of blaDHA, blaEBC, blaMOX and blaCIT genes were 24%, 24%, 4%, and 2% respectively. ERIC-PCR analysis revealed that Enterobacterales isolates were genetically diverse. The remarkable prevalence of MDR Enterobacterales isolates carrying ESBL and AmpC beta-lactamase genes emphasizes that efficient surveillance measures are essential to avoid the more expansion of drug resistance amongst isolates.
摘要：
目标：近年来，由于广谱β-内酰胺酶(ESBLs)和AmpC酶,导致新生儿败血症的肠杆菌多药耐药(MDR)显著增加.这项研究旨在评估抗生素耐药性模式，ESBLs/AmpCβ-内酰胺酶基因的患病率，从新生儿败血症中分离出的肠杆菌和肠杆菌重复基因间共有聚合酶链反应（ERIC-PCR）指纹图谱。
结果：总计，59株肠杆菌，包括41种（69.5%）肠杆菌，分离肺炎克雷伯菌15株(25.4%),大肠埃希菌3株(5.1%)。在所有分离株中均可见对头孢他啶和头孢噻肟的抗性。此外，所有患者均具有多重耐药(对3种不同的抗生素具有耐药性).表型检测显示100%的分离株为ESBL阳性。此外，在84.7%(n=50/59)的分离物中观察到AmpC产生。在59个ESBL阳性分离株中，blaCTX-M-15基因比例最高(66.1%)，其次是blaCTX-M基因(45.8%)，blaCTX-M-14(30.5%),blaSHV（28.8%），和blaTEM（13.6%）。BlaDHA的频率，blaEBC,blaMOX和blaCIT基因为24%,24%,4%,分别为2%。ERIC-PCR分析显示肠杆菌分离株具有遗传多样性。携带ESBL和AmpCβ-内酰胺酶基因的MDR肠杆菌分离株的显着流行强调，有效的监测措施对于避免分离株中耐药性的进一步扩大至关重要。
结果：总计，59株肠杆菌，包括41种（69.5%）肠杆菌，分离肺炎克雷伯菌15株(25.4%),大肠埃希菌3株(5.1%)。在所有分离株中均可见对头孢他啶和头孢噻肟的抗性。此外，所有患者均具有多重耐药(对3种不同的抗生素具有耐药性).表型检测显示100%的分离株为ESBL阳性。此外，在84.7%(n=50/59)的分离物中观察到AmpC产生。在59个ESBL阳性分离株中，blaCTX-M-15基因比例最高(66.1%)，其次是blaCTX-M基因(45.8%)，blaCTX-M-14(30.5%),blaSHV（28.8%），和blaTEM（13.6%）。BlaDHA的频率，blaEBC,blaMOX和blaCIT基因为24%,24%,4%,分别为2%。ERIC-PCR分析显示肠杆菌分离株具有遗传多样性。携带ESBL和AmpCβ-内酰胺酶基因的MDR肠杆菌分离株的显着流行强调，有效的监测措施对于避免分离株中耐药性的进一步扩大至关重要。
