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《医学前沿（英文）》 2018年 第12卷 第2期 页码 182-188 doi: 10.1007/s11684-017-0529-4
With the abuse of antimicrobial agents in developing countries, increasing number of carbapenem-resistant Enterobacteriaceae (CRE) attracted considerable public concern. A retrospective study was conducted based on 242 CRE strains from a tertiary hospital in Hangzhou, China to investigate prevalence and drug resistance characteristics of CRE in southeast China. Bacterial species were identified. Antimicrobial susceptibility was examined by broth microdilution method or epsilometer test. Resistant β-lactamase genes were identified by polymerase chain reaction and sequencing. Genotypes were investigated by phylogenetic analysis. and were the most prevalent types of species, with occurrence in 71.9% and 21.9% of the strains, respectively. All strains exhibited high resistance (>70%) against β-lactam antibiotics, ciprofloxacin, trimethoprim–sulfamethoxazole, and nitrofurantoin but exhibited low resistance against tigecycline (0.8%) and minocycline (8.3%). A total of 123 strains harbored more than two kinds of β-lactamase genes. , , , and were the predominant genotypes, with detection rates of 60.3%, 61.6%, 43.4%, and 16.5%, respectively, and were highly identical with reference sequences in different countries, indicating potential horizontal dissemination. IMP-4 was the most frequent class B metallo-lactamases in this study. In conclusion, continuous surveillance and effective prevention should be emphasized to reduce spread of CRE.
关键词： Enterobacteriaceae carbapenem β-lactamase genes phylogenetic analysis
碳青霉烯类耐药性在人源和动物源产NDM酶大肠埃希菌间的传播 Article
沈应博, 胡付品, 王永强, 尹丹丹, 杨璐, 陈义强, 许春燕, 李基云, 蒋君瑶, 王雪杨, 付玉林, 邵东延, 刘德俊, 马藤菲, 蔡畅, 沈张奇, 王少林, 李娟, 张嵘, 柯跃斌, 吴聪明, 沈建忠, Timothy R. Walsh, 汪洋
《工程（英文）》 2022年 第15卷 第8期 页码 24-33 doi: 10.1016/j.eng.2021.07.030
Although carbapenem use is prohibited in animals in China, carbapenem-resistant Escherichia coli (CREC), especially New Delhi metallo-β-lactamase (NDM)-producing strains, are widely prevalent in foodproducing animals. At present, the impact of livestock-associated CREC strains on human populations at the national level is unknown. Here, we conduct a retrospective cross-sectional study to investigate the prevalence of CREC from clinical settings across 22 Chinese provinces or municipalities and analyze anthropogenic factors associated with their presence. We also ascertain the blaNDM and blaKPC abundance among pig and chicken farms and present a detailed genomic framework for CREC of animal and human origin. Overall, 631/29799 (2.1%) clinical Escherichia coli (E. coli) isolates were identified as CREC. Multivariable analysis revealed that being male, an age below 1, an age between 13 and 18, provinces with greater chicken production, and provinces with higher pig production were associated with higher odds of CREC infection. In general, 73.8% (n = 45/61) of pig farms and 62.2% (n = 28/45) of chicken farms had a blaNDM abundance of 1×10－5 to 1×10－3 and 1×10－3 to 1×10－2, respectively. Among all the Chinese NDM-positive E. coli (n = 463) available at the National Center for Biotechnology Information (NCBI), the genomic analysis revealed that blaNDM-5 and IncX3 were the predominant carbapenemase gene-plasmid combination, while a highly homogeneous relationship between NDM-positive isolates from humans and animals was demonstrated at the plasmid and core genome levels. All the findings suggest frequent CREC transmission between humans and animals, indicating that further discussions on the use of antibiotics in animals and humans are needed, both in China and across the globe.
关键词： Carbapenem resistance Escherichia coli blaNDM-5 One Health Antimicrobial resistance transmission
头孢他啶-阿维巴坦耐药革兰氏阴性菌的流行病学特征及耐药机制 Review
徐婷婷, 郭育奇, 姬扬, 王保红, 周凯
《工程（英文）》 2022年 第11卷 第4期 页码 138-145 doi: 10.1016/j.eng.2020.11.004
细菌的碳青霉烯耐药性是全球公共健康面临的一个重大挑战，由碳青霉烯耐药菌（CRO）引起的临床感染通常有很高的发病率和死亡率。头孢他啶-阿维巴坦（CAZ-AVI）是一种新型头孢菌素/β-内酰胺酶抑制剂，为临床治疗CRO感染提供了一项重要选择。据报道，CAZ-AVI 能够抑制Ambler A类、C类以及部分D类酶的活性。然而，这种药物在临床使用后不久，细菌的耐药性就已经出现，并且呈上升趋势。了解细菌对CAZ-AVI 的耐药机制，对于指导开发新型治疗方法、帮助预测潜在的耐药机制至关重要。本文旨在系统总结CAZ-AVI 耐药菌株的流行病学发展过程和最近发现的CAZ-AVI 耐药机制；将重点关注β-内酰胺酶突变体的产生、β-内酰胺酶高表达、细胞表面通透性降低以及药物外排泵的过表达。短时间内多种CAZ-AVI耐药机制的产生，强调了临床合理用药的重要性以及监测CAZ-AVI 耐药性病原体的必要性。
标题 作者 时间 类型 操作
Prevalence and drug resistance characteristics of carbapenem-resistant Enterobacteriaceae in Hangzhou
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期刊论文
碳青霉烯类耐药性在人源和动物源产NDM酶大肠埃希菌间的传播
沈应博, 胡付品, 王永强, 尹丹丹, 杨璐, 陈义强, 许春燕, 李基云, 蒋君瑶, 王雪杨, 付玉林, 邵东延, 刘德俊, 马藤菲, 蔡畅, 沈张奇, 王少林, 李娟, 张嵘, 柯跃斌, 吴聪明, 沈建忠, Timothy R. Walsh, 汪洋
期刊论文
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