Carbapenemase phenotypic and genotypic assays The antimicrobial susceptibility testing was performed on the experimental strains using an automated VITEK ®2 Compact system (bioMérieux, France) with Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC27853 as the quality control strains, and the results were determined according to the CLSI M100-S32 standard of 2022. Quality control strain: Enterobacter aerogenes ATCC1915. Calibration strain: Escherichia coli ATCC8739. Strain identification of 42 strains of NDM-producing Enterobacteriaceae using matrix-assisted laser desorption time-of-flight mass spectrometry (bioMérieux, France). CRE infections (130) accounted for 1.05% of bacterial infections, and 42 CRE strains were NDM-producing Enterobacteriaceae. A total of 12,373 patients with bacterial infections were collected, 8725 patients were infected with Gram-negative bacteria, and 4987 patients were infected with Enterobacteriaceae. This study screened hospitalized patients in the Fourth Hospital of Hebei Medical University from January 2017 to December 2021. Through retrospective analysis, the distribution characteristics of NDM-type carbapenemases in the Fourth Hospital of Hebei Medical University were clarified, to monitor the development trend of carbapenemases, grasp its epidemic status, and promote the smooth implementation of hospital infection control. In this study, multiple methods were used to detect carbapenemases, and NDM-producing Enterobacteriaceae were screened out in 5 years. The resistance rates of Enterobacteriaceae to imipenem and meropenem in China have climbed year over year and have now increased to nearly 10%, according to data from the China Antimicrobial Surveillance Network (CHINET). Carbapenem-resistant Klebsiella pneumoniae (CRKP) and carbapenem-resistant Escherichia coli (CREC) are the main types of Enterobacteriaceae. Since the discovery of bla NDM−1 in Escherichia coli isolated from India in 2008, NDM-producing Enterobacteriaceae have been widely reported throughout the world, and Asia is thought to be the primary epidemic location. Numerous investigations have demonstrated that the majority of CRE strains produce carbapenemases, the most prevalent carbapenemase genes were KPC and NDM. In recent years, CRE has been reported in different countries and regions. With the widespread use of carbapenems in clinical practice, carbapenem-resistant Enterobacteriaceae (CRE) is increasing. For high-risk patients who have CRE infection, CRE screening should be done as soon as feasible to adopt prompt and efficient intervention measures to prevent outbreaks in the hospital. A total of 8 STs and 4 NDM variants were detected in 16 strains of Escherichia coli, mainly ST410, ST167, and NDM-5. Eight sequence types (STs) and two NDM variants were detected in 11 strains of Klebsiella pneumoniae, primarily ST17, and NDM-1. Molecular typing of NDM-producing Escherichia coli and Klebsiella pneumoniae was carried out by Multilocus Sequence Typing (MLST), and the phylogenetic trees were constructed. Invasive surgery prior to culture, the use of excessive amounts of different antibiotics, the use of glucocorticoids, and ICU hospitalization were clinical characteristics of NDM-producing Enterobacteriaceae infection. The results of antimicrobial susceptibility testing showed that all NDM-producing Enterobacteriaceae were multiple antibiotic resistant, but the sensitivity rate to amikacin was high. Carbapenem genotypes were detected by colloidal gold immunochromatography and real-time fluorescence PCR. The carbapenem phenotype was detected by the modified carbapenem inactivation method (mCIM) and EDTA carbapenem inactivation method (eCIM). The micro broth dilution method combined with the Kirby-Bauer method was used to determine the minimal inhibitory concentrations (MICs) of antibiotics. From January 2017 to December 2021,42 strains of NDM-producing Enterobacteriaceae were gathered from the Fourth Hospital of Hebei Medical University, primarily Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae. The epidemiological characteristics of New Delhi Metallo-β-Lactamase-Producing (NDM) Enterobacteriaceae were analyzed to provide theoretical support for clarifying the distribution characteristics of carbapenem-resistant Enterobacteriaceae (CRE) in the hospital environment and early identification of susceptible patients.
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