Abstract
BackgroundThe rapid emergence and dissemination of carbapenem resistance in Enterobacteriaceae complicates the treatment of infections caused by these organisms.MethodsWe collected clinical isolates with meropenem inhibition zones of ≤ 22 mm from January 1, 2009, through December 31, 2010. We attempted to amplify the NDM-1 gene from these isolates and conducted the modified Hodge test (MHT). The minimal inhibitory concentration (MIC) of the MHT-positive strains was determined by the agar disk dilution method. The carbapenemase-encoding resistance genes of these strains were examined using polymerase chain reaction (PCR) analysis and a sequencing strategy to characterize these enzymes. The clonal relationship among isolates was analyzed by pulsed-field gel electrophoresis (PFGE).ResultsAmong the 158 Enterobacteriaceae isolates that were collected, there were no NDM-1-positive strains and 26 MHT-positive strains. Among the latter, 18 strains were IMP-4-positive, and 1 was KPC-2-positive. In addition, 15 of the IMP-4-positive Klebsiella pneumoniae strains belonged to 4 PFGE genotypes, with 8 strains having the same genotype.ConclusionThese results suggest that nosocomial infections are one of the main reasons for the spread of these resistant strains.
Highlights
Enterobacteriaceae are the most common pathogenic bacteria
Carbapenem antibiotics are a class of β-lactam antibiotics that are often used as a last resort for treating enterobacterial resistance
Enterobacteriaceae isolates (92 K. pneumoniae, 9 E. coli, and 57 Enterobacter cloacae) with reduced susceptibility to imipenem were identified in the hospital
Summary
The emergence of resistant pathogenic bacteria has caused significant problems for the clinical treatment of enterobacterial infections worldwide. There are many mechanisms leading to this resistance [1]. Extendedspectrum β-lactamase (ESBL)-producing pathogenic enterobacteria is a serious problem for antibiotic management because the ESBL genes are transferred from one organism to another via plasmids or other mobile genetic elements in combination with non-β-lactam resistance mechanisms, leading to multidrug-resistant isolates [1,2]. Carbapenem antibiotics are a class of β-lactam antibiotics that are often used as a last resort for treating enterobacterial resistance. Carbapenem-resistant enterobacterial infections are clearly associated with significant morbidity and. The rapid emergence and dissemination of carbapenem resistance in Enterobacteriaceae complicates the treatment of infections caused by these organisms. The clonal relationship among isolates was analyzed by pulsed-field gel electrophoresis (PFGE)
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