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重庆某三甲医院耐碳青霉烯类弗劳地枸橼酸杆菌感染危险因素分析及分子流行病学调查
Molecular epidemiological investigation of carbapenem-resistant Citrobacter freundii infections in a Grade 3 class A hospital in Chongqing
- 第三军医大学学报 2018年40卷第24期 页码：2278-2283
- 作者机构：
400010 重庆，重庆医科大学附属第二医院检验科
- 作者简介：
[王云英, E-mail：yuzhihang1118@sina.com WANG Yunying, E-mail: yuzhihang1118@sina.com
- 基金信息：重庆市科委基础科学与前沿技术研究(一般)项目(cstc2017jcyjAX0065)
DOI：10.16016/j.1000-5404.201807136
中图分类号： R181.34; R378.2; R915收稿：2018-07-18，
修回：2018-09-29，
纸质出版：2018-12-30
- 稿件说明：
移动端阅览
林美芳, 张利军, 向丹, 等. 重庆某三甲医院耐碳青霉烯类弗劳地枸橼酸杆菌感染危险因素分析及分子流行病学调查[J]. 第三军医大学学报, 2018,40(24):2278-2283.
Meifang LIN, Lijun ZHANG, Dan XIANG, et al. Molecular epidemiological investigation of carbapenem-resistant Citrobacter freundii infections in a Grade 3 class A hospital in Chongqing[J]. Journal of Third Military Medical University, 2018, 40(24): 2278-2283.
林美芳, 张利军, 向丹, 等. 重庆某三甲医院耐碳青霉烯类弗劳地枸橼酸杆菌感染危险因素分析及分子流行病学调查[J]. 第三军医大学学报, 2018,40(24):2278-2283. DOI： 10.16016/j.1000-5404.201807136.
Meifang LIN, Lijun ZHANG, Dan XIANG, et al. Molecular epidemiological investigation of carbapenem-resistant Citrobacter freundii infections in a Grade 3 class A hospital in Chongqing[J]. Journal of Third Military Medical University, 2018, 40(24): 2278-2283. DOI： 10.16016/j.1000-5404.201807136.
摘要
目的
2
分析耐碳青霉烯类弗劳地枸橼酸杆菌(Carbapenem resistant Citrobacter freundii，CRCF)感染危险因素及分子流行病学特征。
方法
2
收集来自重庆医科大学附属第二医院2013年1月- 2018年3月138例弗劳地枸橼酸杆菌感染患者临床资料，按照是否对碳青霉烯类抗生素耐药分为两组，CRCF组32例，非CRCF(Non-CRCF，NCRCF)组106例；用卡方检验及多因素logistic回归分析方法分析CRCF感染的危险因素；多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)分析细菌同源性。
结果
2
138株弗劳地枸橼酸杆菌中CRCF检出率为23.2%；多因素logistic回归分析显示肿瘤(
OR
=4.057，95%
CI
=1.574~10.458，
P
=0.004)和手术(
OR
=2.938，95%
CI
=1.160~7.441，
P
=0.023)是CRCF感染的独立危险因素；共有7个MLST克隆型，以ST22(
n
=9)和ST115(
n
=9)型多见，两个新的ST型已被PubMlst数据库收录并分别命名为ST115和ST116；PFGE与MLST分型结果基本保持一致。
结论
2
肿瘤和手术是CRCF感染的独立危险因素；ST22和ST115是CRCF感染的优势克隆型；应加强对CRCF的监测和控制，预防CRCF的播散流行。
Abstract
Objective
2
To analyze the risk factors and molecular epidemiological characteristics of infections with carbapenem-resistant
Citrobacter freundii
(CRCF).
Methods
2
The clinical data were collected from 138 patients with
Citrobacter freundii
infections admitted in our hospital between January
2013 and March
2018. Among these patients
CRCF were isolated from 32 patients and non-resistant
Citrobacter freundii
(
n
CRCF) from 106 patients.
Chi
-square test and multivariate logistic regression analysis were used to identify the clinical risk factors of CRCF
and multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were employed to analyze the homology of the CRCF isolates.
Results
2
Multivariate logistic regression analysis showed that surgery (
OR
=4.057
95%
CI
=1.574-10.458
P
=0.004) and tumor (
OR
=2.938
95%
CI
=1.160-7.441
P
=0.023) were independent risk factors for CRCF infection. Of the 32 CRCF isolates
7 MLST clones were identified
among which ST22 (
n
=9) and ST115 (
n
=9) were the most prevalent; Two new STs were confirmed by the PubMlst database and named ST115 and ST116. The typing results of PFGE were basically consistent with the results of MLST.
Conclusion
2
Surgery and tumors are independent risk factors for CRCF infection
and ST22 and ST115 are the dominant clones in CRCF infection. The finding in this study urges effective measures for surveillance and control of CRCF infections.
关键词
Keywords
references
HAMMERUM A M, HANSEN F, NIELSEN H L, et al . Use of WGS data for investigation of a long-term NDM-1-producing Citrobacter freundii outbreak and secondary in vivo spread of blaNDM-1 to Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca[J ] . J Antimicrob Ch emother, 2016, 71(11): 3117-3124. DOI: 10.1093/jac/dkw289.
WANG J T, WU U I, LAUDERDALE T L, et al . Carbapenem-nonsusceptible Enterobacteriaceae in Taiwan[J ] . PLoS ONE, 2015, 10(3): e0121668. DOI: 10.1371/journal.pone.0121668.
刘淑敏, 杜娜, 刘嘉欣, 等. 2012年至2014年耐碳青霉烯类弗氏柠檬酸杆菌的分布与耐药性[J].昆明医科大学学报, 2016, 37(8): 35-38.
LIU S M, DU N, LIU J X, et al . Distribution and drug resistance of carbapenem-resistant citrobacter freundii from 2012 to 2014[J ] . J Kunming Med Univ, 2016, 37(8): 35-38.
胡付品, 郭燕, 朱德妹, 等. 2017年CHINET中国细菌耐药性监测[J].中国感染与化疗杂志, 2018, 18(3): 241-251. DOI: 10.16718/j.1009-7708.2018.03.001
HU F P, GUO Y, ZHU D M, et al . CHINET 2017 surveillance of bacterial resistance in China[J ] . Chin J Infec Chemoth, 2018, 18(3):241-251.DOI: 10.16718/j.1009-7708.2018.03.001
CHEN S, HU F, LIU Y, et al . Detection and spread of carbapenem-resistant Citrobacter freundii in a teaching hospital in China[J ] . American Journal of Infection Control, 2011, 39(9): e55-e60. DOI:10.1016/j.ajic.2011.02.009.
许建成, 周琪, 刘韶晖, 等.连续5年临床分离弗劳地枸橼酸杆菌的耐药变迁[J].现代预防医学, 2009, 36(9): 1741-1742.
XU J C, ZHOU Q, LIU S H, et al . Changes of drug resistance of citrobacter freundii isolated during past 5 years[J ] . Modern Preventive Medicine, 2009, 36(9): 1741-1742.
WANG Z, QIN R R, HUANG L, et al . Risk factors for carbapenem-resistant klebsiella pneumoniae infection and mortality of klebsiella pneumoniae infection[J ] . Chin Med J, 2018, 131(1): 56-62. DOI:10.4103/0366-6999.221267.
GAGLIOTTI C, GIORDANI S, CICCARESE V, et al . Risk factors for colonization with carbapenemase-producing Klebsiella pneumoniae in hospital: a matched case-control study[J ] . Am J Infect Control, 2014, 42(9): 1006-1008. DOI: 10.1016/j.ajic.2014.05.028.
周静芳, 凌勇, 刘伟江, 等.耐碳青霉烯类肠杆菌科细菌的感染特征和危险因素分析[J].中华医院感染学杂志, 2017, 27(1): 16-19.
ZHOU J F, LING Y, LIU W J, et al . Characteristics and risk factors for carbapenem-resistant Enterobacteriaceae infection[J ] . Chin J Nosocomiol, 2017, 27(1): 16-19.
SWAMINATHAN M, SHARMA S, POLIANSKY BLASH S, et al . Prevalence and risk factors for acquisition of carbapenem-resistant Enterobac teriaceae in the setting of endemicity[J ] . Infect Control Hosp Epidemiol, 2013, 34(8): 809-817. DOI: 10.1086/671270.
向丹, 张利军, 周先玉, 等.耐碳青霉烯类弗劳地枸橼酸杆菌耐药机制及治疗策略研究[J].重庆医学, 2017, 46(26): 3635-3637+3640.
XIANG D, ZHANG L J, ZHOU X Y, et al . Study on drug resistance mechanism in carbapenem-resistant Citrobacter freundii and treatment strategies[J ] . Chongqing Med, 2017, 46(26): 3635-3637+3640.
WANG X, CHEN G, WU X, et al . Increased prevalence of carbapenem resistant Enterobacteriaceae in hospital setting due to cross-species transmission of the bla NDM-1 element and clonal spread of progenitor resistant strains[J ] . Front Microbiol, 2015, 6: 595. DOI: 10.3389/fmicb.2015.00595.
YANAT B, RODR GUEZ-MART NEZ J M, TOUATI A. Plasmid-mediated quinolone resistance in Enterobacteriaceae: a systematic review with a focus on Mediterranean countries[J]. Eur J Clin Microbiol Infect Dis, 2017, 36(3): 421-435. DOI: 10.1007/s10096-016-2847-x.
HE S, CHANDLER M, VARANI A M, et al . Mechanisms of evolution in high-consequence drug resistance plasmids[J ] . mBio, 2016, 7(6). DOI: 10.1128/mbio.01987-16.
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