Ann Lab Med.  2012 Jul;32(4):270-275. 10.3343/alm.2012.32.4.270.

Characterization of Carbapenemase Genes in Enterobacteriaceae Species Exhibiting Decreased Susceptibility to Carbapenems in a University Hospital in Chongqing, China

• Xia Y
• Liang Z
• Su X
• Xiong Y

• KMID: 1380086
• DOI: http://doi.org/10.3343/alm.2012.32.4.270

Abstract

BACKGROUND
Our study was to investigate the prevalence of carbapenemase genes in strains of Enterobacteriaceae species exhibiting decreased susceptibility to carbapenems in our hospital.
METHODS
The carbapenemase producing Enterobacteriaceae species were confirmed by modified Hodge test (MHT) and EDTA-disc synergy test which indicating the production of class B carbapenemases. PCR and sequencing analysis were used to identify the drug-resistant genes. DNA fingerprinting based on enterobacterial repetitive intergenic consensus (ERIC)-PCR was applied to investigate the homology of Enterobacteriaceae species.
RESULTS
From a collection of 1,472 Enterobacteriaceae species, 18 isolates with decreased susceptibility to carbapenem treatment were identified and 9 of which were positive by MHT, and 6 of which produced class B carbapenemases. PCR and sequencing analysis of the 18 isolates revealed 4 different carbapenemase genes (blaIMP-8, blaoxa-1, blaIMP-26, and blaoxa-47) in 10 isolates, with the blaIMP-8 and blaoxa-1 genes being the most common (60-70% prevalence). ERIC-PCR showed 5, 2, and 2 unique genotypes for Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae, respectively. Three E. coli strains isolated from different patients from the urologic surgery department exhibited the same DNA banding pattern, suggesting a possible clonal dissemination. Majority (17/18) of the carbapenem-unsusceptible Enterobacteriaceae species isolates was obtained from the surgery department of our hospital.
CONCLUSIONS
The main carbapenemase genes of Enterobacteriaceae species in our hospital were blaIMP-8 and blaoxa-1. Prevalence of carbapenem resistance may be existed in surgery department and infection control should be taken for preventing further dissemination of drug-resistant strains.

Keyword

Enterobacteriaceae species; Carbapenemases; Carbapenems

MeSH Terms

Anti-Bacterial Agents/*pharmacology
Bacterial Proteins/*genetics
Carbapenems/*pharmacology
China
DNA Fingerprinting
Drug Resistance, Bacterial/drug effects/genetics
Enterobacteriaceae/*drug effects/*enzymology/isolation & purification
Enterobacteriaceae Infections/microbiology
Genotype
Hospitals, University
Humans
Microbial Sensitivity Tests
Sequence Analysis, DNA
beta-Lactamases/*genetics

Figure

• 

  Fig. 1 Representative gel showing banding profiles by ERIC-PCR. (A) Enterobacter cloacae; (B) Escherichia coli; (C) Klebsiella pneumoniae. The number below each lane corresponds to the strain number in Table 2. M: DNA molecular weight marker.

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