科研之友
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摘要
Objective: Carbapenem-resistant Enterobacter cloacae infections are known to be particularly prevalent in vulnerable populations, especially children. However, the phenotypic and molecular characteristics of carbapenem-resistant E. cloacae infections in the pediatric wards of China have not been well described. The aim of the present study was to characterize an outbreak of carbapenem-resistant E. cloacae in a pediatric intensive care unit of a teaching hospital. Methods: A total of 10 non-duplicated carbapenem-resistant E. cloacae from pediatric patients were collected and analyzed by antimicrobial susceptibility testing. The Modified Hodge test (MHT) was used for the preliminary screening of carbapenemases. beta-lactamase genes were examined by PCR for sequencing. The transferability of the carbapenemase genes and the homology of the 10 strains were evaluated by a conjugation experiment and pulsed-field gel electrophoresis (PFGE), respectively. Results: The results showed that all of the 10 isolates exhibited carbapenemase activity and carried carbapenemase genes. The Klebsiella pneumoniae carbapenemase (bla(KPC-2)) genes were detected in 6 of the 10 isolates, the bla(IMP-8) metallo-beta-lactamase gene was detected in 1 isolate. Interestingly, the New Delhi metallo-beta-lactamase (bla(NDM-1)) gene, which is rarely found in children, was identified in 3 isolates. Further, extended spectrum beta-lactamases (ESBLs) and cephalosporinases (AmpC enzyme) genes were detected in the majority of the carbapenem-resistant E. cloacae isolates. All carbapenemase genes were located on transferable plasmids. PFGE demonstrated that 10 carbapenemase-producing E. cloacae isolates had homology and that there were five different clone patterns. Conclusions: Our study indicated that carbapenemase-production was the main contributor to this nosocomial infection outbreak because of the E. cloacae found in the pediatric intensive care unit.
- 出版日期2016
- 单位上海市浦东新区公利医院; 安徽医科大学; 中国人民解放军第二军医大学; 温州医科大学
