The Study Of Surveillance Of Drug Resistance Of Enterobacter Cloacae And Its Carrying Status Of Aminoglycoside Resistance Genes

Objective: 1.To analyze the distribution characteristics of clinical infections and change of drug resistance to common clinical antibiotics of Enterobacter cloacae inThe Affiliated Hospital of Guizhou Medical University from2008 to 2017,in order to provide guidance for the rational use of clinical antibiotics in our hospital.2.To analyze the distribution of aminoglycoside modifying enzyme genes(AMEs genes)and aminoglycoside methylase genes(16SrRNA methylase genes)in our hospital,to understand the resistance mechanism of Enterobacter cloacae to aminoglycoside antibiotics in our hospital.3.At the same time the genotypes of Enterobacter cloacae in our hospital were typed to determine if there was a clonal spread in our hospital.Methods: 1.collecting the data on drug resistance of Enterobacter cloacae in our hospital from 2008 to 2017,and analysing the detection rate of Enterobacter cloacae,the detection of main speciments,the distribution of clinical departments,and the resistance to common clinical antibiotics by using WHONET 5.6 software,retrospectively.2.The 110 strains of Enterobacter cloacae isolated from our hospital from April 2016 to May 2017 were collected.We detected 7 AMEs genes,2 16 S rRNA methylase genes and int I of E.cloacae by PCR amplification.And analyze its relationship with drug resistance phenotype.3.The genomes of 110 E.cloacae strains were typed by ERIC-PCR method to analyze the homology among the strains.Results: 1.During the ten years from 2008 to 2017,a total of 2272 strains of Enterobacter cloacae were isolated in this hospital,,and the highest detection rate was in wound secretions from 2010 to 2017.The Enterobacter cloacae isolated in ten years was mainly from surgery,accounting for 26.45%.Theresistance rate of Enterobacter cloacae to most antibiotics reached the highest in2009.From 2009 to 2017,the resistance rate of Enterobacter cloacae to most antibiotics basically showed a downward trend.Drug susceptibility monitoring results showed that Enterobacter cloacae has the lowest resistance rate to carbapenem antibiotic imipenem over the years.2.A total of five AMEs genes were detected in110 strains of Enterobacter cloacae.The total positive rate of AMEs gene was46.36%(51/110).Among them,the detection rate of aac(6’)-Ib was the highest,and aph(3’’)-VI and aac(3)-I were not detected.The total positive rate of 16 S rRNA methylase gene was 8.18%(9/110),and the positive rate of the intI gene was 47.27%(52/110).Nine out of ten amikacin-resistant strains were detected for aac(3)-III,and the detection rate of aac(6’)-Ib was highest in gentamicin-resistant strains and tobramycin-resistant strains.82.73% of strains have genotypes consistent with drug resistant phenotypes.3.Among 110 strains of Enterobacter cloacae,40 strains were amplified and divided into 20 types,of which the G type was the most,there were 6strains,followed by the O type,there were 5 strains,and the remaining 70 strains did not show bands.Conclusion: 1.In the past ten years,the resistance rate of Enterobacter cloacae to clinical commonly used antibiotics has been on a decreasing trend.Enterobacter cloacae resistant to carbapenem antibiotics deserves attention.2.There was a high coincidence rate between aminoglycoside resistance genes and aminoglycoside antibiotic phenotype of Enterobacter cloacae in our hospital.3.There are cloning and dissemination among the strains of Enterobacter cloacae in our hospital.