中国人群携带mcr相关基因耐药菌株流行现状分析  

Current status of prevalence of drug-resistant strains carrying with mcr-related genes in Chinese population

作　　者：贡鑫然 李志强 吴迪 杨美涛 王彦丁 邹大阳 王勇 GONG Xin-ran;LI Zhi-qiang;WU Di;YANG Mei-tao;WANG Yan-ding;ZOU Da-yang;WANG Yong(School of Public Health,China Medical University,Shenyang,Liaoning 110122,China;不详)

机构地区：[1]中国医科大学公共卫生学院,辽宁沈阳110122 [2]中国人民解放军疾病预防控制中心,北京100071

出　　处：《中华医院感染学杂志》2023年第10期1449-1455,共7页Chinese Journal of Nosocomiology

基　　金：国家传染病重大专项基金资助项目(2018ZX10733402-008)。

摘　　要：目的对中国人群中携带mcr相关基因的阳性菌流行病学特征总结分析,为相关临床研究及科研人员提供参考。方法在PubMed和中国知网分别以“mcr,China”和“mcr”搜索2015-2021年中国境内mcr相关文献,对mcr阳性菌株的分布特征进行分析。结果中国31个省市(区)报告了3745株mcr阳性菌株,mcr-1(3684株)和mcr-3(34株)分离数量最多,尚未在中国人群中发现mcr-6和mcr-7,其余型别数量均少于10株。地区分布上呈现南方高于北方,沿海高于内陆的状况,广东省报道数量最多(1654株),其次是浙江(579株)。埃希菌属中mcr阳性菌最多(1872株),其中mcr-1基因主要由大肠埃希菌携带(1869株),mcr-3基因主要由沙门菌属(10株)和气单胞菌属(9株)携带,7株mcr-8基因阳性菌均为肺炎克雷伯菌,3株mcr-9阳性菌分布在肠杆菌科。时间分布上从2008年开始呈现增加后下降再上升的趋势;样本多来源于住院患者(1615株)和体检人员(1529株),以肠道门诊和胃肠疾病来源为主。2882份标本来源于粪便和直肠拭子。结论mcr基因在中国人群中广泛存在,且阳性菌株仍有增加的趋势,这提示医疗疾控机构应对mcr基因阳性菌进行合理的监测和防控。OBJECTIVE To explore the epidemiological characteristics of the Chinese population carried with mcr genes so as to provide guidance for clinical research.METHODS mcr-related literatures were searched from PubMed and CNKI by setting′mcr,China′and′mcr′as key words,and the distribution of mcr-positive strains was observed.RESULTS Totally 3745 mcr-positive strains were reported in 31 provinces and municipalities,the strains carrying with mcr-1(3684)and mcr-3(34)were dominant.mcr-6 and mcr-7 have not been discovered among the Chinese population,and the strains carrying with other mcr genes were less than 10 strains.The prevalence of the strains was higher in the south than in the north and was higher in the coast than in the inland.Guangdong Province had the largest number of reported strains(1654),followed by Zhejiang(579).Among the Escherichia strains,mcr-positive strains(1872)were dominant,there were 1869 strains of Escherichia coli carrying with mcr-1 gene,there were 10 strains of Salmonella and 9 strains of Aeromonas that carried with mcr-3 gene,there were 7 strains of Klebsiella pneumoniae positive for mcr-8 gene,and there were 3 strains of Enterobacteriaceae positive for mcr-9 gene.The prevalence started to rise then declined and then rose again from 2008.Among the specimens sources,1615 strains were from hospitalized patients,and 1529 strains were from people receiving physical examination;the strains were mainly from enteric diseases clinics and patients with gastrointestinal diseases.There were 2882 specimens sources that were collected from stool and rectal swabs.CONCLUSION mcr gene is highly prevalent among Chinese population,the positive strains show an increasing trend,and it suggests that the medical disease control institutions should carry out the reasonable monitoring of mcr-positive strains and take prevention measures.

关 键 词：mcr-1 携带 多黏菌素 耐药基因 质粒 

分 类 号：R378[医药卫生—病原生物学]