本研究旨在调查碳青霉烯酶产生的流行病学特征和随时间的趋势(例如,KPC,NDM,VIM,IMP,和OXA-48)革兰氏阴性菌(CPGNB)。收集2019年4月至2023年2月郑州大学第一附属医院非重复多重耐药革兰阴性菌(MDRGNB)。使用Vitek2系统进行每种分离物的物种鉴定,并根据制造商的说明通过基质辅助激光解吸电离-飞行时间质谱进行确认。PCR检测到菌株中的碳青霉烯类耐药基因,通过碳青霉烯类失活试验验证后,将携带碳青霉烯类耐药基因的菌株归类为CPGNB菌株.在研究期间共收集了属于78个不同物种的5705个非重复MDRGNB分离株,其中1918年CPGNB进行了验证,呼吸道是标本的主要来源。流行病学统计显示,与其他部门相比,ICU来源的菌株占主导地位。肺炎克雷伯菌,大肠杆菌,鲍曼不动杆菌,铜绿假单胞菌是河南地区最显著的CPGNB,KPC和NDM是主要的碳青霉烯酶。河南省耐碳青霉烯类抗生素感染总体呈上升趋势,碳青霉烯酶基因的携带已变得越来越普遍和复杂。在大流行后时代,CPGNB的流行率越来越高,对公共安全构成了重大挑战。
This study aimed to investigate the epidemiological characteristics and trends over time of carbapenemase-producing (e.g., KPC, NDM, VIM, IMP, and OXA-48) Gram-negative bacteria (CPGNB). Non-duplicated multi-drug resistant Gram-negative bacteria (MDRGNB) were collected from the First Affiliated Hospital of Zhengzhou University from April 2019 to February 2023. Species identification of each isolate was performed using the Vitek2 system and confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry according to the manufacturer\'s instructions. PCR detected carbapenem resistance genes in the strains, strains carrying carbapenem resistance genes were categorized as CPGNB strains after validation by carbapenem inactivation assay. A total of 5705 non-repetitive MDRGNB isolates belonging to 78 different species were collected during the study period, of which 1918 CPGNB were validated, with the respiratory tract being the primary source of specimens. Epidemiologic statistics showed a significant predominance of ICU-sourced strains compared to other departments. Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa were the significant CPGNB in Henan, and KPC and NDM were the predominant carbapenemases. Carbapenem-resistant infections in Henan Province showed an overall increasing trend, and the carriage of carbapenemase genes by CPGNB has become increasingly prevalent and complicated. The growing prevalence of CPGNB in the post-pandemic era poses a significant challenge to public safety.