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《Laboratory Medicine and Clinic》 2018-04
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Analysis of drug resistance of carbapenem-resistant antibiotics and its related influencing factors discussion

LUO Hongying;YU Shuiquan;Department of Laboratory,the Third People′s Hospital of Yibin;Department of Laboratory,Fuling District Central Hospital,Chongqing;  
Objective To analyze and characterize the carbapenemase,integron distribution and the loss of outer membrane pore protein of carbapenem-resistant Enterobacteriaceae.Methods A total of 87 carbapenemresistant strains isolated from clinical specimens of sputum,urine,secretions and blood were collected.A total of 87 isolates of carbapenem-resistant Enterobacteriaceae(CRE)strains were analyzed to discuss the production of carbapenemase,integrin distribution and the outer membrane pore protein in the absence of analysis and characteristics.Results A total of 87 carbapenem antibiotics resistant strains of Enterobacteriaceae(CRE)were amplified by PCR for carbapenemase gene.The results showed that 74 strains of carbapenemase genes were detected,accounting for 85.06%,including Klebsiella pneumoniae 65 strains(87.84%),the highest proportion of detection;In addition,Escherichia coli detected in 6 cases(8.11%),Enterobacter cloacae,Klebsiella oxytoca and Enterobacter aerogenes were detected in 1 patient,accounting for 1.35%.Fifty-two ClassⅠintegrons were detected in the integrase gene,and the detection rate was 59.77%(52/87).47 strains were from carbapenemase-producing strains,5 strains were from non-producing carbapenems,and the highest proportion was detected by Klebsiella pneumoniae(39 cases and 3 cases,respectively).The detection rate of class Ⅱ integrons was 9.20%(8/87),and the positive rate of Klebsiella pneumoniae was the highest,Of which 4 strains were from carbapenemase-producing strains and 4 strains were from non-carbapenemase-producing strains.In this study,class Ⅲ integrons were not detected.Three isolates of classⅠ and class Ⅱ integrons were identified,two were Klebsiella pneumoniae-producing Klebsiella pneumoniae strains and 1 Klebsiella pneumoniae isolates from non-carbapenemase-producing strains.Klebsiella pneumoniae outer membrane pore protein loss analysis results suggest that a total of 70 strains of carbapenem antibiotic-resistant Klebsiella pneumoniae strains,the membrane protein is no abnormal ratio of 18.57%,of which carbapenem producing strain accounting for16.92%;The proportion of down regulated OmpK35 expression was 24.29%,and OmpK35 deletion was 10.00%;The proportion of down regulated OmpK36 was 4.23% and OmpK36 deletion 57.14%,respectively.Among the carbapenem producing strains,the percentage of down regulated OmpK35 was 50.77%,OmpK35 deletion was 9.23%,and the ratio of OmpK36 expression down and deletion was 3.08% and 55.38%,respectively.Conclusion The resistance of carbapenem-resistant Enterobacteriaceae to carbapenemresistant bacteria is severe,and the Klebsiella pneumoniae carbapenemase gene is the most sensitive and the drug-resistant is the most serious.The occurrence of drug resistance is also related to the integrase Gene classⅠintegrons and decreased expression of porcine membrane protein are closely related to the deletion.
【CateGory Index】: R446.5
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