Primary Exploration On The Resistant Mechanism Of Suspicious Epidemic Carbapenem Resistant Enterobacteriaceae

Objective1. To investigate the drug resistance of 41 Carbapene-Resistant Enterobacteriaceae from 2013-2014 to the clinical common antibiotics, in order to provide the date for the clinical appropriate use of antibiotics.2. To investigate the homology distribution of the 41 CRE, so that for further understanding the population of the CRE in our hospital.3. To detect the production of Carbapenemase ? ESBLs ? Amp C and study the expression of the porin in order to clear the resistant mechanism of the CRE and guide the rational use of antibiotics.Methods1. The drug resistance to the common antibiotics of the CRE were analyzed by Vitct-2compact automatic system.2. Kirby-Bauer method was used to test the resistance to Imipenem and Meropenem.3. ERIC-PCR method was used to determine the homology analysis.4. The resistant gene of Carbapenemase?ESBLs?Amp C and gene of OMP were detected by polymerase chain reaction. The gene of Ompk35 and Ompk36 were detected by sequence analysis.5. RT-PCR method was used to investigate the expression of the gene of Ompk35 and Ompk36.Result1. The resistant rate of 41 CRE to ?-lactam antibiotics were high up to 80%, and the susceptibility to Quinolones ? Tetracycline and Aminoglycosides were 85%,ERIC-PCR showed that the department of pediatrics and neonatology have homology strains.2. Modefied Hodge test showed that among the 41 CRE positive were 10 strains,EDTA test show none was positive. The cabapenemase resistant genetic test found none has the resistant gene.3. The drug-resistant genetic test showed the every CRE have at least one?-lactamase gene.4. Out membrane protein research showed none has the lost of gene of Ompk35 and Ompk36, the sequence test of the positive Ompk35 and Ompk36 gene told us 97.22%of the 41 CRE strains have the same structure of the wild type. The RT-PCR result found the low expression of Ompk35 and Ompk36 gene in 91.67%Carbapenem-Resistant Klebsiella pneumoniae and Klebsiella oxytoca.Conclusion The 41 CRE in our hospital have severe resistant rate to the ?-lactam antibiotics,the Quinolones?Tetracycline and Aminoglycosides can be used as an the alternative offer in our clinical treatment. We must focus on the hand hygiere?ward cleaning?disinfction and isolation in the department of pediatrics and neonatology. We didn't find the resistance gene of cabapenemases. The Resistant Mechanism of Carbapene-Resistant Enterobacteriaceae was expression of ?-lactamase gene and the low expression of Ompk35 and(or) Ompk36 gene.