PDF(Pubmed)
Abstract：
BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CRKP) presents a significant challenge to antimicrobial therapy, especially when compounded by resistance to colistin. The objective of this study was to explore molecular epidemiological insights into strains of clinical K. pneumoniae that produce carbapenemases and exhibit resistance to colistin. Eighty clinical isolates of CRKP were obtained from Milad Hospital in Tehran, Iran. Antimicrobial susceptibility and colistin broth disk elution were determined. PCR assays were conducted to examine the prevalence of resistance-associated genes, including blaKPC, blaIMP, blaVIM, blaOXA-48, blaNDM and mcr-1 to -10. Molecular typing (PFGE) was used to assess their spread.
RESULTS: Colistin resistance was observed in 27 isolates (33.7%) using the Broth Disk Elution method. Among positive isolates for carbapenemase genes, the most frequent gene was blaOXA-48, identified in 36 strains (45%). The mcr-1 gene was detected in 3.7% of the obtained isolates, with none of the other of the other mcr genes detected in the studied isolates.
CONCLUSIONS: To stop the spread of resistant K. pneumoniae and prevent the evolution of mcr genes, it is imperative to enhance surveillance, adhere rigorously to infection prevention protocols, and implement antibiotic stewardship practices.
RESULTS: Colistin resistance was observed in 27 isolates (33.7%) using the Broth Disk Elution method. Among positive isolates for carbapenemase genes, the most frequent gene was blaOXA-48, identified in 36 strains (45%). The mcr-1 gene was detected in 3.7% of the obtained isolates, with none of the other of the other mcr genes detected in the studied isolates.
CONCLUSIONS: To stop the spread of resistant K. pneumoniae and prevent the evolution of mcr genes, it is imperative to enhance surveillance, adhere rigorously to infection prevention protocols, and implement antibiotic stewardship practices.
摘要：
背景：产生碳青霉烯酶的肺炎克雷伯菌（CRKP）对抗菌治疗提出了重大挑战，尤其是对粘菌素的抗性复合时。这项研究的目的是探索对产生碳青霉烯酶并表现出对粘菌素抗性的临床肺炎克雷伯菌菌株的分子流行病学见解。从德黑兰的Milad医院获得了80种CRKP临床分离株，伊朗。确定了抗菌药物敏感性和粘菌素肉汤圆盘洗脱。进行PCR检测以检查耐药相关基因的流行情况，包括BlaKPC,blaIMP,BlaVIM,blaOXA-48、blaNDM和mcr-1至-10。分子分型（PFGE）用于评估其传播。
结果：使用肉汤盘洗脱方法在27个分离株（33.7％）中观察到粘菌素抗性。在碳青霉烯酶基因阳性分离株中，最常见的基因是blaOXA-48，在36株（45％）中鉴定。3.7%的分离株检测到mcr-1基因,在研究的分离株中没有检测到其他mcr基因。
结论：为了阻止耐药肺炎克雷伯菌的传播和防止mcr基因的进化，必须加强监视，严格遵守感染预防协议，并实施抗生素管理实践。
结果：使用肉汤盘洗脱方法在27个分离株（33.7％）中观察到粘菌素抗性。在碳青霉烯酶基因阳性分离株中，最常见的基因是blaOXA-48，在36株（45％）中鉴定。3.7%的分离株检测到mcr-1基因,在研究的分离株中没有检测到其他mcr基因。
结论：为了阻止耐药肺炎克雷伯菌的传播和防止mcr基因的进化，必须加强监视，严格遵守感染预防协议，并实施抗生素管理实践。
