Abstract
BackgroundThe molecular characteristics of carbapenem-resistant Escherichia coli (CREco) remain unclear.MethodsWe conducted a multi-center bacterial resistance monitoring project from 2015 to 2017.The minimum inhibitory concentrations ofCREco were determined bybroth microdilution method. The genome sequencing of CREcoisolates was performed, and single-nucleotide polymorphism (SNP) was analyzed.ResultsA total of 144CREcoisolatescollected from 10 cities in China were involved in this study. ST167 (n = 43) is the most popular type, followed by ST410(n = 14), ST131(n = 9). There were 102 (70.83%) CREco isolates that produced various NDMs, including NDM-1 (n = 16), NDM-4(n = 1), NDM-5(n = 79), NDM-6(n = 2) and NDM-9(n = 4). In addition, 15 isolates produced KPC-2, three isolates wereIMP-4 positive, and three isolates produced OXA-48. Genetic relatedness and phylogenetic analysis showed that isolates with the same ST had a high degree of homology. Some STs (including ST167, ST410, ST131, ST46, ST405 and ST617) exhibited a trend of outbreak.ConclusionsThe majority of CREco belonged to ST167, followed by ST410 and ST131, and most of them carried various NDM-coding genes. The spread of high-risk clones of CREco has occurred in different regions of China.
Highlights
With the widespread of Extended-Spectrum βLactamases (ESBLs) in Enterobacteriaceae, the clinical efficacy of third-generations of cephalosporins,fluoroquinolones and aminoglycosidesin the treatment of Extended-Spectrum β-Lactamase (ESBL)-positive Enterobacter infection gradually decreased, which makes carbapenems have become thelasteffective antimicrobialagentsto control of infections caused by multi-drug resistant Enterobacteriaceae [1,2,3]
Distribution of clinical carbapenem-resistant Escherichia coli (CREco) isolates From 2015 to 2017, 144clinical CREco isolates were collected from 10 cities across China, including Beijing (n = 77), Zhengzhou (n = 14), Xian (n = 12), Jinan (n = 9), Shanghai (n = 8), Shenyang (n = 8), Guiyang (n = 4), Chengdu (n = 6), Guangzhou (n = 3) and Lanzhou (n = 3)
The resistance rate ofcarbapenemaseproducingCREco to imipenem and meropenem was higher than that ofcarbapenemase-negative isolates (P < 0.0001) according to chi-square test, and GraphPad.Prism.V7.0 was used for statistical analysis
Summary
With the widespread of Extended-Spectrum βLactamases (ESBLs) in Enterobacteriaceae, the clinical efficacy of third-generations of cephalosporins,fluoroquinolones and aminoglycosidesin the treatment of ESBL-positive Enterobacter infection gradually decreased, which makes carbapenems have become thelasteffective antimicrobialagentsto control of infections caused by multi-drug resistant Enterobacteriaceae [1,2,3]. Carbapenem-resistant Escherichia coli (CREco) is currently one of the main pathogens of CRE causing various clinical infections [5, 6]. According to a statistical result of CDC in the United States, the proportion of CREco was only 0.9% from 2006 to 2007, but it increased to 1.9% from 2009 to 2010 [1, 7]. In Europe, a recent survey showed that 19% of E. coli strains were CREco during 2013 to 2014 [2, 8]. In China, the monitoring results from 2004 to 2015 showed that the proportion of CREco remained at 0.8 to 3% during the ten years [3, 9]. The molecular characteristics of carbapenem-resistant Escherichia coli (CREco) remain unclear
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