■肺炎克雷伯菌和耐碳青霉烯类肺炎克雷伯菌(CRKP)的发病率不断上升,给临床抗感染治疗带来了巨大挑战。这里,我们描述了来自中国不同地区住院患者的肺炎克雷伯菌和CRKP分离株的分子流行病学和抗菌药物耐药谱.
■在2019-2020年期间,从中国19个省的26家医院收集了219株肺炎克雷伯菌分离株。抗菌药物敏感性试验,进行多位点序列分型,通过聚合酶链反应(PCR)检测抗菌药物耐药基因。比较不同组间的抗菌药物耐药情况。
■肺炎克雷伯菌对亚胺培南的耐药率,美罗培南,厄他培南占20.1%,20.1%,和22.4%,分别。共鉴定出45株CRKP分离株。45株CRKP和174株碳青霉烯类敏感型肺炎克雷伯菌(CSKP)的耐药性差异有统计学意义,CRKP分离株具有多药耐药表型特征。肺炎克雷伯菌对头孢唑啉的耐药率存在区域差异,氯霉素,和磺胺甲恶唑,西北比中国北部和南部低。最常见的序列类型(ST)是ST11(占菌株的66.7%)。此外,我们检测到其他13个STs。ST11和非ST11菌株对阿米卡星的耐药率存在差异,庆大霉素,latamoxef,环丙沙星,左氧氟沙星,氨曲南,呋喃妥因,磷霉素,和头孢他啶/阿维巴坦.在分子抗性机制方面,大多数CRKP菌株(71.1%,32/45)藏有blaKPC-2,其次是blaNDM(22.2%,10/45).携带blaKPC或blaNDM基因的菌株对某些抗生素表现出不同的敏感性。
■我们的分析强调了监测碳青霉烯耐药决定因素并分析其分子特征的重要性,以更好地管理临床使用的抗菌药物。
UNASSIGNED: The increasing incidence of Klebsiella pneumoniae and carbapenem-resistant Klebsiella pneumoniae (CRKP) has posed great challenges for the clinical anti-infective treatment. Here, we describe the molecular epidemiology and antimicrobial resistance profiles of K. pneumoniae and CRKP isolates from hospitalized patients in different regions of
China.
UNASSIGNED: A total of 219 K. pneumoniae isolates from 26 hospitals in 19 provinces of
China were collected during 2019-2020. Antimicrobial susceptibility tests, multilocus sequence typing were performed, antimicrobial resistance genes were detected by polymerase chain reaction (PCR). Antimicrobial resistance profiles were compared between different groups.
UNASSIGNED: The resistance rates of K. pneumoniae isolates to imipenem, meropenem, and ertapenem were 20.1%, 20.1%, and 22.4%, respectively. A total of 45 CRKP isolates were identified. There was a significant difference in antimicrobial resistance between 45 CRKP and 174 carbapenem-sensitive Klebsiella pneumoniae (CSKP) strains, and the CRKP isolates were characterized by the multiple-drug resistance phenotype.There were regional differences among antimicrobial resistance rates of K. pneumoniae to cefazolin, chloramphenicol, and sulfamethoxazole,which were lower in the northwest than those in north and south of China.The mostcommon sequence type (ST) was ST11 (66.7% of the strains). In addition, we detected 13 other STs. There were differences between ST11 and non-ST11 isolates in the resistance rate to amikacin, gentamicin, latamoxef, ciprofloxacin, levofloxacin, aztreonam, nitrofurantoin, fosfomycin, and ceftazidime/avibactam. In terms of molecular resistance mechanisms, the majority of the CRKP strains (71.1%, 32/45) harbored blaKPC-2, followed by blaNDM (22.2%, 10/45). Strains harboring blaKPC or blaNDM genes showed different sensitivities to some antibiotics.
UNASSIGNED: Our analysis emphasizes the importance of surveilling carbapenem-resistant determinants and analyzing their molecular characteristics for better management of antimicrobial agents in clinical use.