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墨西哥产碳青霉烯酶肠杆菌科细菌:一家儿童医院 7 例非克隆病例报告。

Carbapenemase-producing Enterobacteriaceae in Mexico: report of seven non-clonal cases in a pediatric hospital.

机构信息

Molecular Microbiology Laboratory, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Insurgentes Cuicuilco, ZC, 04530, Coyoacán Mexico City, Mexico.

Pediatric Infectious Disease Department, Instituto Nacional de Pediatria, Mexico City, Mexico.

出版信息

BMC Microbiol. 2018 Apr 19;18(1):38. doi: 10.1186/s12866-018-1166-z.

Abstract

BACKGROUND

Carbapenemases-producing Enterobacteriaceae (CPE) are a worldwide public health emergency. In Mexico, reports of CPE are limited, particularly in the pediatric population. Here, we describe the clinical, epidemiological, and molecular characteristics of seven consecutive cases in a third-level pediatric hospital in Mexico City over a four-month period during 2016.

RESULTS

The Enterobacteriaceae identified were three Escherichia coli strains (producing OXA-232, NDM-1 and KPC-2), two Klebsiella pneumoniae strains (producing KPC-2 and NDM-1), one Klebsiella oxytoca strain producing OXA-48 and one Enterobacter cloacae strain producing NDM-1. The majority of patients had underlying disesases, three were immunocompromised, and three had infections involved the skin and soft tissues. Half patients died as a result of CPE infection.

CONCLUSIONS

This study represents the first report of E. coli ST131-O25b clone producing NDM-1 in Latin America. In addition, this study is the first finding of K. oxytoca producing OXA-48 and E. coli producing OXA-232 in Mexican pediatric patients.

摘要

背景

产碳青霉烯酶肠杆菌科(CPE)是全球公共卫生紧急事件。在墨西哥,CPE 的报告有限,特别是在儿科人群中。在此,我们描述了 2016 年在墨西哥城一家三级儿科医院的四个月期间连续发生的七例病例的临床、流行病学和分子特征。

结果

鉴定出的肠杆菌科细菌包括三株大肠埃希菌(产 OXA-232、NDM-1 和 KPC-2)、两株肺炎克雷伯菌(产 KPC-2 和 NDM-1)、一株产 OXA-48 的产酸克雷伯菌和一株产 NDM-1 的阴沟肠杆菌。大多数患者存在基础疾病,三例免疫功能低下,三例感染涉及皮肤和软组织。一半的患者因 CPE 感染而死亡。

结论

本研究代表了在拉丁美洲首次发现产 NDM-1 的大肠埃希菌 ST131-O25b 克隆。此外,本研究首次发现了产 OXA-48 的产酸克雷伯菌和产 OXA-232 的大肠埃希菌在墨西哥儿科患者中的存在。

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