Molecular epidemiological characteristics and risk factors analysis of Carbapenem-resistant Enterobacterales intestines colonization of neonates in Shenzhen region
10.3760/cma.j.cn112150-20250207-00091
- VernacularTitle:深圳地区新生儿肠道携带耐碳青霉烯类肠杆菌目细菌的分子流行特征及其危险因素分析
- Author:
Hongmei YANG
1
;
Ke CAO
;
Zhile XIONG
;
Xiaochun LIU
;
Kaiyue YANG
;
Yunxing HE
;
Shaoxiang LIN
;
Jiahe ZOU
;
Shuyan LIU
;
Tongyan DING
;
Lingfan YIN
;
Zhixiang LI
;
Chaohui DUAN
;
Zhenwen ZHOU
Author Information
1. 广东医科大学第一临床学院，湛江 524001
- Publication Type:Journal Article
- Keywords:
Neonate;
Intestinal;
Carbapenem-resistant enzyme;
Drug resistance
- From:
Chinese Journal of Preventive Medicine
2025;59(7):1022-1030
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.
