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Mechanism for carbapenem resistance of clinical Enterobacteriaceae isolates

Yafei Ye1, Lijuan Xu1, Yanping Han1

  • 1Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450002, P.R. China.

Experimental and Therapeutic Medicine
|February 6, 2018
PubMed

Insights

Carbapenemase-producing superbugs are a global threat. This study found that carbapenem resistance in Enterobacteriaceae is mainly due to carbapenemase production, often combined with outer membrane protein loss.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Public Health

Background:

  • Carbapenemase-producing Enterobacteriaceae (CPE) represent a significant global health challenge.
  • NDM-1 and its variants are key drivers of carbapenem resistance.

Purpose of the Study:

  • To investigate the molecular mechanisms of carbapenem resistance in clinical Enterobacteriaceae isolates.
  • To identify the prevalence of carbapenemases, ESBLs, and AmpC enzymes in resistant strains.

Main Methods:

  • Screening of 78 carbapenem-resistant Enterobacteriaceae strains.
  • Detection of outer membrane porin (OMP) proteins using SDS-PAGE.
  • Identification of carbapenemase, ESBL, and plasmid AmpC genes via PCR.

Main Results:

  • 60.3% of strains produced carbapenemases, with KPC-2 being prevalent (33.3%).
  • Loss or reduction of OMP proteins (OmpK35/36, OmpC/F) was observed in a majority of resistant strains.
  • 35.9% of strains lost at least one OMP, indicating multiple resistance mechanisms.

Conclusions:

  • Carbapenemase production is the primary mechanism for carbapenem resistance in these clinical isolates.
  • Outer membrane protein deletion or mutation contributes significantly to carbapenem resistance.
  • Combined mechanisms, including carbapenemases and OMP alterations, drive resistance in Enterobacteriaceae.
Keywords:
SDS-PAGEcarbapenem-resistant enterobacteriaceaepolymerase chain reaction

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