关键词: 阴沟肠杆菌, 碳青霉烯类抗生素, NDM-1基因检测, 回顾性报告

Abstract: Objective A retrospective analysis in terms of clinical characteristics and detection was carried out for a case of Enterobacter cloacae bearing NDM-1 isolated from a urine specimen of an in-patient in our hospital in July 2012. The purpose of this paper was to render suggestions for controlling the epidemic of“superbugs”based on discussions regarding its antibiotic-resistant characterization and mechanism. Methods According to the recommendations of CLSI, susceptibility testing for antibiotics using K-B and MIC methods was performed. Carbapenemase production and its phenotypic were confirmed by modified Hodge test and metal-enzyme test. PCR for detecting and sequencing the antibiotic-resistance gene was also performed. Results This isolate was resistant to 15 antibiotics such as imipenem, meropenem and others which were classiifed into 7 categories. This isolation showed positive for modiifed Hodge test and screening test for detecting metal-enzyme phenotype. The DNA sequence of the isolation amplified by PCR showed 99%similarities comparing with NDM-1 gene cited in Genbank. It was conifrmed as the ifrst report of E. cloacae carrying NDM-1 by the CDC of Heibei Province.Conclusion The NDM-1-producing isolation may be related to the elder patient who was inifrm, catheterized and experienced multi-drug treatments. Therefore, in order to lessen the incidents of multi-drug resistant strain, it is ideal that we should focus on the control over catheterization, the use of antibiotics and taking strict sterilization.

Key words: Enteroba cter cloacae, carbapenems antibiotics, NDM-1 gene detection, retrospective report