Antibiotic Resistance Of Enterobacterobacteriaceae Bacteria And Study On The Distribution Of Common Carbapenems In Henan Province

ObjectiveThe purpose of the study is to estimate the antimicrobial resistance of Enterobacteriaceae and the rate of infection with carbapenem-resistant Enterobacteriaceae in various regions of Henan province,and to study the clinical distribution characteristics and the distribution of common carbapenems,so as to provide reference for clinical rational application of antibiotics.Method1 WHONET was used to collect and analyze the resistance of Enterobacteriacea in Henan Province and the prevalence of carbapenem-resistant Enterobacteriaceae in various regions,and the resistance of Escherichia coli and Klebsiella pneumoniae to the third-generations cephalosporins,quinolones and carbapenems in different regions,and the resistance of Escherichia coli and Klebsiella pneumoniae detected in the secondary hospitals and the tertiary hospitals to the three kinds of antibiotics.2 There were 180 carbapenem-resistant Enterobacteriaceae strains collected from 109 hospitals in 18cities,and the minimal inhibitory concentrations（MICs）of 21 antibiotics were determined using the microdilution broth method.3 To detect carbapenem-producing Enterobacteriaceae,a polymerase chain reaction assay was performed to detect four carbapenemase genes(bla _KPC,bla _NDM,bla _VIM,bla _IMP).4 Statistical analysis was performed using SPSS version 22.0（IBM for Windows）.p<0.05 was considered to be statistically significant.Result1 Carbapenem resistant rates in Enterobacteriacea,Klebsiella pneumonia and Enterobacteria.coli were11.6%（4324/37283）,24.6%（2979/12187）and 2.7%（434/16339）in 109 hospitals of Henan province respectively.Only small proportion of Enterobacteriaceae were resistant toβ-lactam,carbapenems,tigecycline and polymyxin.The highest prevalence of CREC is in Kaifeng（5.7%）,and the highest prevalence of CRKP is in Ruzhou（42.0%）.The prevalence CRKP resistant to quinolones and carbapenems in secondary and tertiary hospitals are significantly different（P<0.01）.2 Almost all of the CRKP isolates resistant to cephalosporins,sulfonamides,aminoglycosides,aztreonam.Tigecycline and polymyxin B have good effection in vitro activity agginst CRKP(MIC_50/90,0.5/1μg/ml;MIC_50/90,0.25/1μg/ml,respectively).Total CREC isolates were reisistant to cephlosporins andβ-lactam antibiaotics.There was no Escherichia coli resistant to tigecycline and polymyxin B has been detected,and the MIC₅₀and MIC₉₀of them were 0.25,0.5;0.25,1μg/ml,.3 The bla _KPC（92.0%,81/88）gene was the major carbapenem gene harbored by CRE strains,followed by NDM in Henan province.And bla _KPCwas the major carbapenem gene in most regions of Henan province.ConclusionWe determined the serious prevalence of carbapenem resistance among Enterobacterieacea isolates in Henan province and the different prevalence of carbapenem resistance among Enterobacteriaeceae isolates in different regions.Therefore,it is necessary to strength the monitoring and control of hospital-acquired infection in local hospital.CRE has serious resistance to various antibacterial drugs according to local epidemic characteristics and microbial drug sensitivity results in Henan province.CRE mainly carries KPC-producing enzyme-based drug resistance genes,but the major carbapenem-resistant genes carried by CRE in some areas may need further research in Henan province.