Identificación de enterobacterias productoras de carbapenemasas en el Hospital Universitario Católico de Cuenca / Identification of carbapenemase producing enterobacteriaceae at the Catholic University Hospital of Cuenca / Identificação de enterobacteriaceae produtoras de carbapenemase no Hospital Universitário Católico de Cuenca

Las enterobacterias productoras de carbapenemasas desarrollan infecciones resistentes a los medicamentos en neumonía, infección del tracto urinario e infecciones relacionadas con dispositivos. Klebsiella pneumoniae, Escherichia coli y Enterobacter cloacae son amenazas de resistencia emergentes importantes a nivel mundial, lo que representa alta mortalidad y limitadas opciones de tratamiento. Objetivo: detectar la presencia de EPC de clase A, mediante la aplicación del test fenotípico de sinergia con ácido borónico en cepas de enterobacterias aisladas de superficies inertes en el Hospital Universitario Católico de Cuenca, Ecuador. Materiales y Métodos: estudio cuali-cuantitativo de tipo experimento puro de corte transversal y alcance exploratorio - descriptivo. Las enterobacterias se identificaron mediante test bioquímicos del sistema estandarizado API 20 E. Para la detección fenotípica de carbapenamasas de clase A se utilizó el método de sinergia de discos con ácido borónico y discos imipenem, meropenem y ertapenem. Resultados: se identificaron 25 géneros de enterobacterias, el 24 % fue Pseudomonas aeruginosam, el 20 % de enterobacterias fue productoras de carpapenemasas clase Am mientras que el 32 % fue resistente para los tres carbapenémicos en estudio, el 68 % mostró sensibilidad para imipenem, el 56 % para meropenem y 44 % para ertapenem. El 48 % de enterobacterias fueron resistentes a ertapenem, el 44 % a meropenem y 32 % a imipenem. Conclusiones: Enterobacterias como P. aureginosa, E. cloacae, Cronobacter spp. y E. coli presentan mecanismos de resistencia asociados a carbapenemasas clase A tipo KPC por lo que se recomienda vigilancia continua y estrategias de manejo para abordar la resistencia a carbapenémicos en entornos hospitalarios

Carbapenemase-producing Enterobacteriaceae develop drug-resistant infections in pneumonia, urinary tract infection, and device-related infections. Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae are important emerging resistance threats globally, representing high mortality and limited treatment options. Objective: detect the presence of class A EPC, by applying the phenotypic synergy test with boronic acid in strains of enterobacteria isolated from inert surfaces at the Catholic University Hospital of Cuenca, Ecuador. Materials and Methods: Qualitative-quantitative study of pure cross-sectional experiment type and exploratorydescriptive scope. Enterobacteriaceae were identified using biochemical tests of the standardized API 20 E system. For the phenotypic detection of class A carbapenamases, the synergy method of disks with boronic acid and imipenem, meropenem and ertapenem disks was used. Results: 25 genera of enterobacteria were identified, 24 % were Pseudomonas aeruginosam, 20 % of enterobacteria were producers of class Am carbapenemases while 32 % were resistant to the three carbapenems under study, 68 % showed sensitivity to imipenem, 56 % for meropenem and 44 % for ertapenem. 48 % of enterobacteria were resistant to ertapenem, 44 % to meropenem and 32 % to imipenem. Conclusions: Enterobacteriaceae such as P. aureginosa, E. cloacae, Cronobacter spp. and E. coli present resistance mechanisms associated with class A carbapenemases type KPC, so continuous surveillance and management strategies are recommended to address resistance to carbapenems in hospital environments

Enterobacteriaceae produtoras de carbapenemases desenvolvem infecções resistentes a medicamentos em pneumonia, infecção do trato urinário e infecções relacionadas a dispositivos. Klebsiella pneumoniae, Escherichia coli e Enterobacter cloacae são importantes ameaças emergentes de resistência em todo o mundo, representando alta mortalidade e opções de tratamento limitadas. Objetivo: detectar a presença de CPE classe A, aplicando o teste de sinergia fenotípica com ácido borônico em cepas de enterobactérias isoladas de superfícies inertes no Hospital Universitário Católico de Cuenca, Equador. Materiais e Métodos: estudo cualitativo quantitativo, do tipo experimento transversal puro e escopo exploratório-descritivo. As enterobactérias foram identificadas por meio de testes bioquímicos do sistema padronizado API 20 E. Para a detecção fenotípica das carbapenamases classe A foi utilizado o método de sinergia de discos com ácido borônico e discos de imipenem, meropenem e ertapenem. Resultados: foram identificados 25 gêneros de enterobactérias, 24 % eram Pseudomonas aeruginosam, 20 % das enterobactérias eram produtoras de carbapenemases da classe Am enquanto 32 % eram resistentes aos três carbapenêmicos em estudo, 68 % apresentaram sensibilidade ao imipenem, 56 % ao meropenem e 44. % para ertapenem. 48 % das enterobactérias eram resistentes ao ertapenem, 44 % ao meropenem e 32 % ao imipenem. Conclusões: Enterobacteriaceae como P. aureginosa, E. cloacae, Cronobacter spp. e. coli apresentam mecanismos de resistência associados às carbapenemases classe A tipo KPC, portanto estratégias contínuas de vigilância e manejo são recomendadas para abordar a resistência aos carbapenêmicos em ambientes hospitalares.

Calidad higiénico-sanitaria y prácticas de manufactura de alimentos en un comedor estudiantil en México / Hygienic ­ sanitary quality and food manufacturing practices in a student cafeteria in Mexico / Qualidade higiênico-sanitária e práticas de fabricação de alimentos em uma refeitório estudantil no México

Introducción: El apego a las normas oficiales sanitarias sirve para prevenir riesgos a la salud humana. Objetivo: Evaluar la calidad higiénico-sanitaria y las buenas prácticas de manufactura de alimentos (BPMA) de un comedor estudiantil en México. Materiales y métodos: Estudio cuasiexperimental y analítico. Durante el año 2020, se realizaron pruebas bacteriológicas a muestras de alimentos, agua, superficies y manos de manipuladores de alimentos, además de también evaluar las BPMA. Conforme a las normas oficiales sanitarias vigentes en México, se recolectaron 57 muestras, se aislaron y se lograron identificar patógenos. Las BPMA se valoraron en 20 manipuladores, antes y después de una intervención educativa de 10 semanas de duración y se utilizó la prueba t con α=0,05. Resultados: Más del 50 % de las muestras resultaron con microorganismos de riesgo para la salud, como Escherichia coli, Staphylococcus aureus, Pseudomonas, Acinetobacter baumanni complex y Coliformes totales. Las evaluaciones, antes y después de la intervención educativa de BPMA, evidenciaron diferencias estadísticamente significativas en el número de aciertos (p≤0,05). Conclusiones: La calidad higiénico-sanitaria del comedor analizado representó riesgo para la salud de los estudiantes, lo cual tuvo relación con la primera evaluación de las BPMA entre los manipuladores, las cuales mejoraron después de la intervención.

Introduction: Adherence to official health standards is essential to prevent human health risks. Objective: To assess the hygienic-sanitary quality and good food manufacturing practices (GMP) in a student cafeteria in Mexico. Materials and methods: Quasi-experimental and analytical study. During 2020, bacteriological tests were carried out on samples taken from food, water, surfaces, and hands of food handlers. In addition, GMP were evaluated. Based on the current Mexican official health regulations, 57 samples were collected to isolate and identify pathogens. GMP were assessed in 20 food handlers before and after a 10-week training intervention and a test was used with α=0.05. Results: More than 50% of samples were found to have microorganisms associated with health risks, including Escherichia coli, Staphylococcus aureus, Pseudomonas, Acinetobacter baumanni complex and total Coliforms. The analyses before and after the GMP training intervention showed statistically significant differences in terms of the presence of these pathogens (p≤0.05). Conclusions: The hygienic-sanitary quality of the analyzed cafeteria turned out to be a risk for the health of students, which was related to the first assessment of GMP in food handlers. Consequently, the results improved after the intervention.

Introdução: A adesão às normas sanitárias oficiais serve para prevenir riscos à saúde humana. Objetivo: Avaliar a qualidade higiênico-sanitária e as boas práticas de fabricação de alimentos (BPMA) de um refeitorio estudantil no México. Materiais e métodos: Estudo quase-experimental e analítico. Durante 2020, foram realizados testes bacteriológicos em amostras de alimentos, água, superfícies e mãos de manipuladores de alimentos, além de avaliação de BPMA. De acordo com as normas sanitárias oficiais em vigor no México, foram coletadas e isoladas 57 amostras e identificados patógenos. Os BPMA foram avaliados em 20 manipuladores, antes e após uma intervenção educativa de 10 semanas e foi utilizado o teste t com α=0,05. Resultados: Verificou-se que mais de 50% das amostras continham microrganismos de risco à saúde, como Escherichia coli, Staphylococcus aureus, Pseudomonas, complexo Acinetobacter baumanni e Coliformes totais. As avaliações, antes e após a intervenção educativa BPMA, apresentaram diferenças estatisticamente significativas no número de acertos (p≤0,05). Conclusões: A qualidade higiênico-sanitária do refeitório analisado representou um risco para a saúde dos alunos, o que esteve relacionado à primeira avaliação do BPMA entre os manipuladores, que melhorou após a intervenção.

Identificação de Enterococcus SPP e Enterobacteriaceae em canais radiculares com infecção primária e secundária ou persistente / Identification of Enterococcus spp and Enterobacteriaceae in root canals with primary and secondary or persistent infection

O objetivo do presente estudo foi identificar microrganismos das espécies Enterococcus spp e Enterobacteriaceae em dentes com canais radiculares infectados portadores de infecção primária e/ou secundária/persistente. Métodos: A amostra do presente estudo foi de 23 pacientes que apresentaram necessidade de tratamento ou retratamento endodôntico. Foram coletadas amostras de 28 dentes infectados usando pontas de papel absorventes estéreis, transportadas em solução salina, diluídas, plaqueadas e incubadas em estufa de cultura bacteriológica. Para o crescimento de microrganismos foram utilizados jarros com gerador de atmosfera de anaerobiose. Colônias microbianas foram isoladas, caracterizadas e identificadas. Os dados coletados foram estatisticamente analisados com a utilização do software SPSS for Windows 10.0 (SPSS Inc., USA). Resultados: Foi isolada somente uma cepa do gênero Enterococcus spp, e nenhuma espécie do gênero Enterobacteriaceae. Das coletas microbiológicas realizadas em 28 canais radiculares, todas apresentaram crescimento microbiano em anaerobiose. Dezoito dentes apresentavam necrose pulpar e lesão periapical. Os outros 10 dentes já haviam recebido tratamento endodôntico prévio e em 6 destes houve constatação de lesão periapical, sendo que nos outros 4, não. Conclusão: Nas condições experimentais do presente estudo, pode-se concluir que não houve correlação da presença de espécies microbianas das famílias Enterococcus spp e/ou Enterobacteriaceae com infecção primária ou secundária do canal radicular.

The objective of the present study was to identify microorganisms of the Enterococcus spp and Enterobacteriaceae species in teeth with infected root canals with primary and/or secondary/persistent infection. Methods: The sample of the present study consisted of 23 patients who required endodontic treatment or retreatment. Samples of 28 infected teeth were collected using sterile absorbent paper points, transported in saline solution, diluted, plated and incubated in a bacteriological culture oven. For the growth of microorganisms, jars with an anaerobic atmosphere generator were used. Microbial colonies were isolated, characterized and identified. The collected data were statistically analyzed using the SPSS for Windows 10.0 software (SPSS Inc., USA). Results: Only one strain of the genus Enterococcus spp was isolated, and no species of the genus Enterobacteriaceae. From the microbiological collections carried out in 28 root canals, all showed microbial growth in anaerobic conditions. Eighteen teeth had pulp necrosis and periapical lesion. The other 10 teeth had already received previous endodontic treatment and in 6 of them there was a periapical lesion, and in the other 4, no. Conclusion: Under the experimental conditions of the present study, it can be concluded that there was no correlation between the presence of microbial species of the Enterococcus spp and/or Enterobacteriaceae families with primary or secondary root canal infection.

Resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario en pacientes ambulatorios / Antimicrobial resistance of Enterobacteriaceae causing urinary tract infection in ambulatory patients / Resistência antimicrobiana de Enterobacteriaceae causadora de infecção do trato urinário em pacientes ambulatoriais

Las infecciones del tracto urinario son consideradas un problema de salud a nivel hospitalario y comunitario por el aumento de bacterias resistentes a los antibióticos. Objetivo: Analizar el patrón de susceptibilidad y resistencia antimicrobiana de Enterobacterias causante de infección del tracto urinario. Métodos: Se aplicó una investigación descriptiva de diseño documental. La población fue de 672 registros de urocultivos positivos, recopilados de la base de datos del Laboratorio San Pablo en el periodo 2021-2022. Para su tabulación y análisis los datos obtenidos fueron procesados en el Software SPSS versión 25.0. Resultados: Las ITU se presentan con mayor frecuencia en el género femenino 86,5%. El grupo etario con más afección es la edad adulta 50,4%. El agente etiológico con mayor incidencia fue Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. La producción de BLEE como mecanismo de resistencia predominaron en las cepas de E.coli y Klebsiella spp. Se encontró un mayor porcentaje de resistencia para Ampicilina y SXT. Los antibióticos con mejor sensibilidad destacaron nitrofurantoína, fosfomicina. Conclusión: La especie con mayor aislamiento, implicada en la etiología de infecciones urinarias sigue siendo E.coli con una sensibilidad alta para nitrofurantoína y fosfomicina.

Urinary tract infections are considered a health problem at hospital and community level due to the increase of antibiotic resistant bacteria. Objective: To analyze the pattern of susceptibility and antimicrobial resistance of Enterobacteriaceae causing urinary tract infection. Methods: A descriptive research of documentary design was applied. The population was 672 records of positive urine cultures, collected from the San Pablo Laboratory database in the period 2021-2022. For tabulation and analysis, the data obtained were processed in SPSS software version 25.0. Results: UTIs occur more frequently in females 86.5%. The age group with the highest incidence was adulthood 50.4%. The etiological agent with the highest incidence was Escherichia coli 75.74%, Citrobacter Freundii 8.93%, Klebsiella spp 6.10%. The production of BLEE as a mechanism of resistance predominated in the strains of E.coli and Klebsiella spp. A higher percentage of resistance was found for Ampicillin and SXT. The antibiotics with the best sensitivity were nitrofurantoin and fosfomycin. Conclusion: The species with the highest isolation, implicated in the etiology of urinary tract infections, continues to be E.coli with a high sensitivity to nitrofurantoin and fosfomycin.

As infecções do trato urinário são consideradas um problema de saúde a nível hospitalar e comunitário devido ao aumento de bactérias resistentes aos antibióticos. Objetivo: Analisar o padrão de suscetibilidade e resistência antimicrobiana das Enterobacteriaceae causadoras de infecções do trato urinário. Métodos: Foi aplicada uma metodologia de investigação documental descritiva. A população foi de 672 registros de culturas de urina positivas, coletados do banco de dados do Laboratório San Pablo no período de 2021-2022. Para tabulação e análise, os dados obtidos foram processados no software SPSS versão 25.0 Resultados: As ITUs ocorreram com maior frequência no sexo feminino 86,5%. A faixa etária com maior incidência foi a adulta 50,4%. O agente etiológico com maior incidência foi a Escherichia coli 75,74%, Citrobacter Freundii 8,93%, Klebsiella spp 6,10%. A produção de BLEE como mecanismo de resistência predominou em E. coli e Klebsiella spp. Foi encontrada uma maior percentagem de resistência para a ampicilina e o SXT. Os antibióticos com melhor sensibilidade foram a nitrofurantoína e a fosfomicina. Conclusão: A espécie com maior isolamento, implicada na etiologia das infecções do trato urinário, continua a ser a E. coli com uma elevada sensibilidade à nitrofurantoína e à fosfomicina.

Advances in the Treatment of Carbapenem-Resistant Enterobacteriaceae Infection / 医药导报

With the continuous development of medical science and the widespread use of antibiotics,the problem of bacterial resistance is increasing,especially the increasing carbapenem-resistant Enterobacteriaceae(CRE)infection,and the high mortality rate,which brings great challenges to clinical treatment.In this paper,the mechanism of drug resistance,existing antibac-terial drugs,and exploratory treatment options for CRE are reviewed,and the research progress in treating CRE infection is dis-cussed to provide more reliable evidence and a theoretical basis for clinical practice.

Risk factor analysis of carbapenem-resistant enterobacteriaceae infection based on machine learning / 国际检验医学杂志

Objective To explore the machine learning model and risk factor analysis for hospital infection caused by carbapenem-resistant enterobacteriaceae(CRE).Methods The clinical data of totally 451 patients infected with extended-spectrum β-lactamases(ESBL)producing Enterobacteriaceae treated in the hospital from 2018 to 2022 were retrospectively collected.The patients were divided into CRE group(115 cases)and sensitive group(336 cases)according to the susceptibility of carbapenem.Four machine learning methods in-cluding Logistic regression analysis,random forest,support vector machine,and neural network were used to build prediction models and receiver operating characteristic curve was used to evaluate.Based on the predic-tion model with the best performance,risk factors for CRE infection were analyzed.Results Random forest model had the best performance,with the area under the curve of 0.952 3.The risk factors for predicting CRE infection by the random forest model included 15 clinical data items,namely fever for more than 3 days,cere-bral injury,drainage fluid sample,trunk surgery,first-level or special-level nursing,ICU treatment,procalcito-nin,anti-anaerobic bacteria,the use of third-generation cephalosporins,age,pre-albumin,creatinine,white blood cell count,and albumin.Conclusion The CRE prediction model developed in this study has good predic-tive value and the risk factors have guiding significance for the early prevention and treatment of CRE infec-tion in clinical practice.

Efficacy and safety analysis of tigecycline and polymyxin B in the treatment of carbapenem-resistant enterobacteriaceae pneumonia in critically ill patients / 中国临床药理学与治疗学

AIM: To compare the efficacy and safety of tigecycline with polymyxin B in the treatment of carbapenem resistant enterobacteriaceae (CRE) pneumonia in critically ill patients. METHODS: A retrospective analysis was performed on the clinical data of patients with CRE pneumonia who received tigecycline or polymyxin B therapy from January 1, 2018 to Jun 30, 2023 in the Intensive Care Unit (ICU). Primary outcomes included the 28-day all-cause mortality and clinical cure rate within 28days. Secondary outcomes included the ICU mortality, in-hospital mortality, the length of hospital stay and ICU stay, microbial eradication, duration of mechanical ventilation. Independent predictors affecting 28-day clinical cure rate were tested using Cox regression analyses. RESULTS: A total of 83 eligible patients were included in the final analysis after propensity score matching, 54 in the tigecycline group and 29 in the polymyxin B group. The 28-day all-cause mortality was 31.5% (17/54) in the tigecycline group and 37.9% (11/29) in the polymyxin B group, the difference was not statistically significant (P=0.554); the clinical cure rate was 63% (34/ 54) in the tigecycline group, which was significantly higher than that of the polymyxin B group of 34.5% (10/29) (P = 0.013). There were no statistical differences between the two groups in terms of secondary outcomes. Multivariate logistic regression analysis found that the use of tigecycline was an independent predictor of the 28-day clinical cure rate (HR 2.083, 95%CI 1.018-4.263, P = 0.045). However, activated partial thromboplastin time (APTT) and prothrombin time (PT) were significantly prolonged in the tigecycline group compared with the polymyxin B group (P=0.047; P=0.027), and fibrinogen (FIB) was significantly decreased (P < 0.001) after drug administration. CONCLUSION: There was no significant difference in 28-day all-cause mortality between the tigecycline and polymyxin groups; tigecycline might be associated with a higher 28-day clinical cure rate compared with polymyxin B. It should be noted that tigecycline may increase the risk of coagulation abnormalities.

Progress on surveillance of Carbapenem-resistant Enterobacteriaceae colonization in children / 中国小儿急救医学

Carbapenem-resistant Enterobacteriaceae（CRE）is one of the common pathogens of hospital-acquired infections and has been widely spread in various countries，becoming one of the important public health problems worldwide.With the increase in the proportion of pediatric patients with CRE infections，studies related to the prevention and the control of CRE nosocomial infections have focused more on this group in recent years.Early prevention is particularly important because of the very limited treatment options for CRE infections and the high morbidity and mortality rates.Active screening，as a core measure to prevent CRE infection，has been implemented in several countries in recent years and has been shown to have a positive effect on the prevention and control of nosocomial infection in CRE.The target population of active screening generally includes people in close contact with CRE patients and people at high risk of CRE infection；screening specimens are mostly used in perianal swabs or rectal swabs；detection methods include bacterial culture and molecular detection techniques，with the former being the main method；the timing of screening is to collect the initial specimen within 24 hours of new admission，and follow up people at high risk of infection with regular testing.

Evolución de la resistencia a los antibióticos de los microorganismos aislados de pie diabético infectado

Objetivos: evaluar la evolución de la resistencia a los antibióticos de los microorganismos aislados de pie diabético infectado en pacientes atendidos en el Hospital Clínico Viedma, en las gestiones 2014, 2016, 2018 y 2021. Métodos: investigación observacional, descriptiva, retrospectiva, transversal con enfoque cuantitativo, 268 cultivos y antibiogramas de pacientes con diagnóstico de infección de pie diabético fue la muestra analizada con un 2,82 % de error máximo admitido. Resultados: se identificaron 312 microorganismos, con 71,5 % las bacterias Gram negativas fueron las más frecuentes, de estas la Klebsiella spp con 17,9 % y Escherichia coli con 17,6 % predominaron, cuya resistencia a la ciprofloxacina, sulfatrimetoprim y gentamicina aumentó, los bacilos Gram negativos no fermentadores más aislados fueron las Pseudomonas spp y el Acinetobacter spp cuya resistencia a las cefalosporinas, ciprofloxacina y carbapenémicos incrementó. Por otro lado, con 16,3 % el Staphylococcus aureus fue la bacteria Gram positiva más identificada, la resistencia a la meticilina de 17 % en 2014 aumentó a 25 % en 2021. Conclusiones: las enterobacterias fueron los microorganismos aislados con más frecuencia, cuya resistencia se asoció a la producción de betalactamasas de espectro extendido (BLEE).

Objectives: to evaluate the evolution of antibiotic resistance of microorganisms isolated from infected diabetic foot in patients treated at the Viedma Clinical Hospital, in the 2014, 2016, 2018 and 2021 administrations Methods: observational, descriptive, retrospective, cross-sectional research with a quantitative approach, 268 cultures and antibiograms of patients with a diagnosis of diabetic foot infection were the sample analyzec with a 2,82 % maximum admitted error. Results: 312 microorganisms were identified, with 71,5% Gram- negative bacteria were the most frequent, of these Klebsiella spp with 17,9 % and Escherichia coli with 17,6% predominated, whose resistance to ciprofloxacin, sulfa trimethoprim and gentamicin increased, the most isolated non-fermenting Gram negative bacilli were Pseudomonas spp and Acinetobacter spp whose resistance to cephalosporins, ciprofloxacin and carbapenems increased. On the other hand, with 16,3 % Staphylococcus aureus was the most identified Gram-positive bacteria, methicillin resistance from 17 % in 2014 increased to 25 % in 2021. Conclusions: enterobacteriaceae were the most frequently isolated microorganisms, whose resistance was associated with the production of extended spectrum beta-lactamases (ESBL).

Estudo microbiológico da ostra invasora Saccostrea cucullata: variação sazonal de coliformes totais e termotolerantes no Complexo Estuarino de Cananéia durante a temporada de 2018-2019 / Microbiological study of the invasive oyster Saccostrea cucullata: seasonal variation of total and thermotolerant coliforms in the Cananéia Estuarine Complex during the 2018-2019 season

No complexo estuarino lagunar de Cananéia, estado de São Paulo, região sudeste, há o consumo in natura da ostra invasora Saccostrea cucullata, principalmente no verão, alta temporada. Trata-se de um molusco filtrador que apresenta riscos de graves patologias do sistema gastrointestinal devido ao risco de armazenamento de agentes microbiológicos que afetam o ser humano. A falta de monitoramento, boas práticas de fabricação, qualidade da água e medidas de controle para garantir a segurança e qualidade do consumo de ostras é necessária para a prevenção de patógenos na saúde pública. Este estudo realizou análises microbiológicas de amostras de ostras, com foco em bactérias mesófilas, bactérias psicrotróficas e fungos/leveduras. Além disso, investigou-se as concentrações sazonais de coliformes totais e termotolerantes em amostras de ostras coletadas ao longo de um ano. As contagens de bactérias mesófilas nas ostras variaram de 1,45±0,22 a 3,32±0,28 log UFC g­1, com valores médios de 2,24±0,86 log UFC g­1. Para bactérias psicrotróficas nas amostras de ostras variou entre 1,34±0,29 e 3,12±0,45 log UFC g­1. Os dados revelaram que as contagens de fungos e leveduras variaram de 2,65±0,23 a 3,57±0,22 log UFC g­1. A contagem máxima de S. aureus foi de 1,24 log UFC g­1, e 83,5% das amostras apresentaram resultado negativo para este microrganismo. Não foi detectada presença de Salmonella spp. nas amostras analisadas. Esses resultados fornecem insights importantes sobre a variação sazonal e as contagens microbiológicas em amostras de ostras, destacando a relevância da monitorização e controle microbiológico em produtos alimentícios marinhos.

In the estuarine lagoon complex of Cananéia, state of São Paulo, southeast region, there is fresh consumption of the invasive oyster Saccostrea cucullata, mainly in summer, high season. It is a filter-feeding mollusk that presents a risk of serious pathologies of the gastrointestinal system due to the risk of storing microbiological agents that affect humans. The lack of monitoring, good manufacturing practices, water quality and control measures to ensure the safety and quality of oyster consumption is necessary for the prevention of pathogens in public health. This study carried out microbiological analyzes of oyster samples, focusing on mesophilic bacteria, psychrotrophic bacteria and fungi/yeasts. Furthermore, seasonal concentrations of total and thermotolerant coliforms were investigated in oyster samples collected over a year. Counts of mesophilic bacteria in oysters ranged from 1.45±0.22 to 3.32±0.28 log CFU g­1, with average values of 2.24±0.86 log CFU g­1. For psychrotrophic bacteria in oyster samples it ranged between 1.34±0.29 and 3.12±0.45 log CFU g­1. The data revealed that fungal and yeast counts ranged from 2.65±0.23 to 3.57±0.22 log CFU g­1. The maximum S. aureus count was 1.24 log CFU g­1, and 83.5% of the samples tested negative for this microorganism. No presence of Salmonella spp. was detected in the analyzed data. These results provide important insights into seasonal variation and microbiological counts in oyster samples, highlighting the relevance of microbiological monitoring and control in marine food products.

EVOLUCIÓN DE LAS COLONIZACIONES E INFECCIONES POR BACTERIAS PRODUCTORAS DE CARBAPENEMASAS EN UN HOSPITAL PEDIÁTRICO / EVOLUTION OF COLONIZATIONS AND INFECTIONS BY BACTERIA PRODUCERS OF CARBAPENEMASSES IN A HOSPITAL PEDIATRIC

La emergencia de bacterias productoras de carbapenemasas (BPC) representa un problema de salud pública. La vigilancia epidemiológica constituye una herramienta fundamental para el control de la diseminación

The emergence of carbapenemase-producing bacteria (PCBs) represents a public health problem. Epidemiological surveillance constitutes a fundamental tool for the control of dissemination

Risk factors for extended-spectrum beta-lactamase- and carbapenem- resistant Enterobacteriaceae in patients with urinary tract infection from a tertiary care hospital

Background: Urinary tract infection (UTI) is a common health problem in both community and nosocomial settings. However, the predisposing factors which are responsible for production of extended spectrum beta-lactamase (ESBL) and carbapenem-resistant Enterobacteriaceae makes the treatment option narrow and cause multidrug resistance. Aim and Objectives: This study demonstrate various risk factors associated with multidrug resistance in Enterobacteriaceae from UTI at tertiary care center in Gujarat. Material and Methods: A retrospective observational study was conducted at a tertiary-care hospital. Urine samples were received from various departments and outpatient department (OPD). Organisms from Enterobacteriaceae group were isolated and identified by various biochemical methods. ESBL and Carbapenemase producing organisms were then processed for Antibiotic susceptibility test as per CLSI guideline. Results: A total of 196 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. The most prevalent in people aged 45–65 years (36%) followed by those aged 17–30 (22%) years. UTI due to ESBL and Carbapenemase producer are more isolated in female (28%, 11%) as compare to male (16%, 6%). Indoor patients had higher prevalence of ESBL (29%) and carbapenemases (10%) isolation compare to OPD patient (ESBL-15%, Carbapenemases-7%) and among them most common ward was medicine department. The most common predisposing factor was catheterization followed by diabetes mellitus and obstructive uropathy. Conclusion: High prevalence of ESBL and Carbapenemase producing Enterobacteriaceae is found in Indoor patients than OPD patients. Most of these patients are from Medicine department. Catheterization is the most common risk factor associated with ESBL and carbapenemase producing organism.

Mecanismos de resistencia a la colistina, la nitrofurantoína y la fosfomicina en Enterobacterales / Mechanisms of resistance to colistin, nitrofurantoin and fosfomycin in Enterobacteriaceae

Resumen Las enterobacterias son un grupo amplio y heterogéneo de bacilos Gram negativos que se aíslan de forma rutinaria en el laboratorio clínico y se asocian a una gran cantidad de cuadros clínicos. Aquellas resistentes a antibióticos de última línea, como a los carbapenémicos, representan un gran reto en los centros de salud. Ante la dificultad para tratar infecciones causadas por este tipo de bacterias, se ha retomado el uso de antimicrobianos clásicos como la colistina, la nitrofurantoína y la fosfomicina. El objetivo de este trabajo es detallar los principales mecanismos de resistencia para estos tres fármacos descritos en enterobacterias. Para ello, se efectuó una revisión bibliográfica de artículos científicos publicados entre los años 1999 y 2022, utilizando las bases de datos PubMed (NCBI), PLOS, Redalyc, Google Scholar y Science Direct. En este proceso, se usaron las palabras clave "Carbapenem-Resistant Enterobacteriaceae", "colistin", nitrofurantoin", "fosfomycin", "resistance" y "plasmids". Se encontró que los mecanismos de resistencia son variados y abarcan fenómenos como modificación del sitio blanco, inactivación enzimática, impermeabilidad y eflujo. Además, los determinantes genéticos de resistencia se encuentran en cromosomas o en plásmidos. Conocer este tipo de información permite mejorar la vigilancia basada en el laboratorio, combatir el problema de resistencia a los antimicrobianos y optimizar el uso de estos antibióticos que forman parte del escaso arsenal para el tratamiento de ciertas infecciones causadas por microorganismos multidrogorresistentes.

Abstract Enterobacteriaceae is a large and heterogeneous group of Gram-negative bacilli that are routinely isolated in the clinical laboratory and are associated with a large number of clinical conditions. Those resistant to last-line antibiotics, such as carbapenems, represent a great challenge in health-care centers. Given the difficulty in treating this type of infections, the use of old drugs such as colistin, nitrofurantoin and fosfomycin has been studied. The objective of this work is to detail the main resistance mechanisms described in Enterobacteriaceae for these three antibiotics. To do this, a survey of scientific articles from the years 1999 to 2022 was carried out using databases such as PubMed (NCBI), Google Scholar, PLOS, Redalyc and Science Direct. In this process, keywords "Carbapenem- Resistant Enterobacteriaceae", "colistin", nitrofurantoin", "fosfomycin", "resistance" and "plasmids" were used. Resistance mechanisms were found to be varied and involve phenomena such as target site modification, enzyme inactivation, impermeability, and efflux. In addition, the genetic determinants of resistance are found at the chromosomal level or in plasmids. Knowing this type of information makes it possible to improve laboratory-based surveillance, fight the problem of resistance to antibiotics and take care of these antibiotics, which are part of the scarce arsenal for the treatment of certain infections caused by multidrug-resistant microorganisms.

Detection and correlation of antimicrobial resistance pattern in Enterobacteriaceae from UTI patients in GMERS Medical College, Gujarat

Background: Bacterial resistance to antibiotics is a growing public health threat worldwide. The increasing rate of antimicrobial resistance among bacterial pathogens causing both hospital- and community-acquired infections is a serious threat to public health world-wide. This inappropriate and non-judicious usage of antibiotics has resulted in the development of worldwide antibiotic resistance in bacteria, leading to the emergence of multi-resistant strains of bacterial pathogens. This study focuses on the prevalence of antibiotic resistance in the Enterobacteriaceae group of organisms in urine samples and also detects various methods of antibiotic resistance. Antibiotic resistance detection may be useful for epidemiological and research purposes, as well as for preventing the spread of drug-resistant organisms within hospitals through good infection control practices. Aims and Objectives: The aim of the study was to detect occurrence of ?-lactamases, extended-spectrum beta-lactamases (ESBL) and Carbapenemase by phenotypic methods in Enterobacteriaceae from urine samples along with pattern of antibiotic resistance for various antibiotics in them. Materials and Methods: A descriptive study was conducted at a tertiary-care hospital. Testing of ESBL and carbapenemase production detection done according to CLSI (M100) guideline by the Kirby-Bauer disk diffusion method, combination disc diffusion test, and modified Carbapenem inactivation method. Results: A total of 220 Enterobacteriaceae organisms were isolated from processed urine samples of tertiary care Hospitals. Rate of cephalosporin resistance in ESBL and carbapenem-resistant Enterobacteriaceae (CRE) is more than 90% while in non-ESBL more than 70% and in non-CRE 75–80%. Carbapenem resistance in ESBL and non-ESBL is the same. Resistance to fluoroquinolone group, Aminoglycoside group, and Cotrimoxazole and Tetracycline group of antibiotics were more noticed in ESBL and carbapenemase producing organisms. In our study, fosfomycin and Nitrofurantoin are effective treatment in case of ESBL and CRE producing organism. Conclusion: The ESBL and Carbapenemase producing isolates were multi-drug resistant making therapeutic choices limited. Fosfomycin and Nitrofurantoin are effective treatment in multidrug resistance urinary tract infection.

Prevalência e perfil de suscetibilidade aos antimicrobianos de Escherichia coli em uroculturas de pacientes atendidos em um hospital de ensino / Prevalence and antimicrobial susceptibility profile of Escherichia coli in urine cultures from patients treated at a teaching hospital

Introdução: As infecções do trato urinário (ITU) são geralmente causadas por bactérias da ordem Enterobacterales, principalmente por Escherichia coli uropatogênica (UPEC). Esta linhagem apresenta fatores de virulência que a torna capaz de colonizar e infectar o trato urinário. Apesar da maioria dos quadros de ITU ser solucionado com terapia antimicrobiana, linhagens de UPEC resistentes aos antimicrobianos representam uma séria ameaça à saúde pública. Objetivo: Avaliar a prevalência de Escherichia coli em uroculturas de pacientes atendidos em um hospital de ensino, bem como seu perfil de suscetibilidade aos antimicrobianos e os fenótipos de resistência. Material e Métodos: Trata-se de um estudo descritivo que analisou uroculturas de pacientes ambulatoriais e hospitalares atendidos em um hospital de ensino localizado no município de Juiz de Fora, Minas Gerais, Brasil, no período de janeiro de 2020 a dezembro de 2021. Resultados: Entre as uroculturas analisadas, 858 foram positivas para bactérias, sendo Escherichia coli a espécie predominante, com 27,2% (n= 233) dos isolados. Das 858 uroculturas: 608 foram de pacientes hospitalizados, com 124 (20,4%) isolados de UPEC; 250 foram de pacientes ambulatoriais, com 109 (43,6%) isolados de UPEC. O perfil de resistência aos antimicrobianos das linhagens isoladas nas amostras hospitalares e ambulatoriais, foi, respectivamente: 65% e 32% para ampicilina; 56% e 26% para amoxicilina + ácido clavulânico; 50% e 26% para ciprofloxacino; 42% e 33% para sulfazotrim; 38% e 20% para cefepime; 17% e 8% para gentamicina; 2,5% e 0,4% para ertapenem, meropenem e imipenem. Das linhagens de Escherichia coli resistentes aos beta-lactâmicos, 43 (18%) apresentaram fenótipos de resistência do tipo beta lactamase de espectro ampliado (ESBL) e 7 (3%) foram produtoras de carbapenemases. Conclusão: Escherichia coli foi a espécie mais isolada das uroculturas. UPEC apresentou taxas de resistência a todos os antimicrobianos testados, produzindo fenótipos do tipo ESBL e carbapenemase, principalmente em amostras de pacientes hospitalizados.

Introduction: Urinary tract infections (UTI) are usually caused by bacteria of the Enterobacterales order, mainly by uropathogenic Escherichia coli (UPEC). This strain has virulence factors that make it able to colonize and infect the urinary tract. Although most cases of UTI are resolved with antimicrobial therapy, antimicrobial-resistant UPEC strains pose a serious threat to public health. Objective: To assess the prevalence of Escherichia coli in urine cultures of patients treated at a teaching hospital, as well as their antimicrobial susceptibility profile and resistance phenotypes. Material and Methods: This is a descriptive study that analyzed urine cultures of outpatient and hospital patients treated at a teaching hospital located in the city of Juiz de Fora, Minas Gerais, Brazil from January 2020 to December 2021. Results: Among the analyzed urine cultures, 858 were positive for bacteria, with Escherichia coli being the predominant species, with 27.2% (n= 233) of the isolates. Of the 858 urine cultures: 608 were from hospitalized patients, with 124 (20.4%) UPEC isolates; 250 were from outpatients, with 109 (43.6%) UPEC isolates. The antimicrobial resistance profile of the strains isolated from hospital and outpatient samples was, respectively: 65% and 32% for Ampicillin; 56% and 26% for Amoxicillin+Clavulanic acid; 50% and 26% for Ciprofloxacin; 42% and 33% for Sulfazotrim; 38% and 20% for Cefepime; 17% and 8% for Gentamicin; 2.5% and 0.4% for Ertapenem, Meropenem and Imipenem. Of the Escherichia coli strains resistant to beta-lactams, 43 (18%) showed extended-spectrum beta-lactamase (ESBL) resistance phenotypes and 7 (3%) were carbapenemases producers.Conclusion: Escherichia coli was the most isolated species from urine cultures. UPEC showed rates of resistance to all tested antimicrobials, producing ESBL and carbapenemase-like phenotypes, mainly in samples from hospitalized patients.

Effects of bifidobacterium combined with salicylic acid on skin inflammation and intestinal mcroecology in acne patients with chloasma / 中国基层医药

Objective:To investigate the effects of bifidobacterium combined with salicylic acid on skin inflammation and intestinal microecology in acne patients with chloasma.Methods:Sixty acne patients with chloasma who received treatment in the Department of Cosmetic Dermatology, Wenzhou Heping Plastic Hospital from July 2020 to November 2021 were included in this study. They were randomly divided into three groups: lifestyle intervention group ( n = 20), bifidobacterium combined with salicylic acid intervention group ( n = 20), and isotretinoin intervention group ( n = 20). The lifestyle intervention group was treated by routine lifestyle care. The minocycline intervention group was administered with minocycline together with food based on lifestyle intervention. The bifidobacterium combined with salicylic acid intervention group was treated by bifidobacterium combined with salicylic acid based on lifestyle intervention. Clinical efficacy, skin condition score, changes in serum Toll like receptor 2 (TLR-2) and interleukin-17 (IL-17) levels after treatment relative to those before treatment, and the incidence of adverse reactions were compared among the three groups. Results:The response rate in the bifidobacterium combined with salicylic acid intervention group was 95.00% (19/20), which was higher than 55.00% (11/20) in the isotretinoin intervention group and significantly higher than 20.00% (4/20) in the lifestyle intervention group ( Z = 22.94, P < 0.05). After 14 weeks of treatment, the skin condition score in the bifidobacterium combined with salicylic acid intervention group was (53.15 ± 0.23) points, which was significantly higher than (32.95 ± 0.23) points in the isotretinoin intervention group and (10.18 ± 0.25) points in the lifestyle intervention group ( F = 164 761.37, P < 0.05). Serum levels of Toll-like receptor 2 and interleukin-17 in the bifidobacterium combined with salicylic acid intervention group were (35.31 ± 5.52) pg/mL and (164.23 ± 10.12) pg/mL, respectively, which were significantly lower than (52.13 ± 5.45) pg/mL and (198.32 ± 10.23) pg/mL in the isotretinoin intervention group and (62.56 ± 6.11) pg/mL and (245.23 ± 11.31) pg/mL in the lifestyle intervention group ( F = 116.33, 296.24, both P < 0.05). The incidence of adverse reactions in the bifidobacteria combined with salicylic acid intervention group was significantly lower than 65.00% (13/20) in the isotretinoin intervention group and 90.00% (18/20) in the lifestyle intervention group ( Z = 41.02, P < 0.05). Conclusion:Bifidobacterium combined with salicylic acid intervention for the treatment of acne complicated by chloasma can greatly improve skin conditions, alleviate skin inflammation, and reduce adverse reactions. Therefore, bifidobacterium combined with salicylic acid intervention is a safe and highly efficient method for the treatment of acne complicated by chloasma and deserves clinical promotion.

The level and significance of CD64 index, matrix metalloproteinase-9 and serum amyloid A in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae infection / 中国医师杂志

Objective:To investigate the level and significance of CD64 index, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae (CRE) infection.Methods:A total of 61 patients with severe CRE infection who were admitted to the neurosurgery department of Kashgar First People′s Hospital from January 2019 to January 2022 were selected as the CRE group, and 100 patients with severe carbapenem sensitive Enterobacteriaceae (CSE) infection were selected as the CSE group. The difference in clinical data between the two groups was compared, and the difference in clinical data between the dead and surviving patients in the CRE group was compared. The value of CD64 index, MMP-9 and SAA in differential diagnosis of CRE was analyzed. Logistic regression was used to analyze the influencing factors of prognosis in patients with CRE infection.Results:The age, hypertension, lung disease, liver and kidney disease, comorbidities≥2, antibiotic use≥2 combinations, antibiotic use time>10 days, proportion of carbapenem use, CD64 index, MMP-9, and SAA of the CRE group patients were significantly higher than those of the CSE group patients (all P<0.05). The area under the receiver operating characteristic (ROC) curve for CD64 index, MMP-9, and SAA differential diagnosis of CRE was 0.857, 0.701, and 0.655, respectively (all P<0.05). In the CRE group, the age , the score of Acute Physiological and Chronic Health Status Ⅱ (APACHE Ⅱ) score at admission, diabetes, liver and kidney diseases, comorbidities≥2, the proportion of carbapenems, CD64 index, MMP-9 and SAA of dead patients were significantly higher than those of survivors (all P<0.05). Logistic regression analysis showed that age, APACHE Ⅱ score at admission, comorbidities≥2, CD64 index, MMP-9, and SAA were influencing factors for the prognosis of severe CRE patients (all P<0.05). Conclusions:The peripheral blood CD64 index, MMP-9, and SAA have certain application value in the diagnosis of neurological severe CRE infection, and are also influencing factors for the prognosis of CRE infected patients.

Evaluation of NG-Test Carba5 for rapid detection of carbapenemases / 中华检验医学杂志

Objective:To evaluate the clinical value of NG-Test Carba5 for rapid detection of carbapenemases produced by carbapenem-resistant Enterobacteriaceae (CRE) strains. Methods:A total of 1 210 CRE strains were collected during 2018-2022 from 77 hospitals in 21 provinces of China and were subjected to NG-Test Carba5 for rapid detection of carbapenemase. The whole genome sequencing (WGS) analysis was referenced as the gold standard method.Results:Overall, the NG-Test Carba5 demonstrated excellent performance in detection of five kinds of carbapenemases [Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), imipenemase metallo-β-lactamase (IMP), Verona integron-encoded metallo-beta-lactamase (VIM) and oxacillinase-48-type carbapenemases(OXA-48)] from CRE strains, with a sensitivity of 98.47% (1 161/1 179), specificity of 100% (31/31), and positive predictive value of 100% (1 161/1 161). The sensitivity for detection of NDM, IMP, OXA and VIM reached 100% (307/307), and 97.70% (763/781) for KPC. For 11 strains carrying blaKPC-25, blaKPC-78, or blaKPC-93, NG-Test Carba5 reported positive KPC detection (11/11). For strains carrying blaKPC-33 and blaKPC-77, however, NG-Test Carba5 delivered negative results. Additionally, for those strains co-producing two or three kinds of carbapenemases, NG-Test Carba5 was able to report all of the targets with a sensitivity of 100% (91/91). Conclusions:NG-Test Carba5 showed excellent performance in rapid and accurate detection of carbapenemases from CRE strains. Nonetheless, for those strains with negative results, some other phenotypic and genotypic methods should be implemented alongside to avoid missing targets.

The incidence of intestinal colonization of carbapenem-resistant Enterobacterales and its risk factors for bloodstream infection / 中华检验医学杂志

Objective:The aim of this study was to determine the colonization rate of carbapenem-resistant Enterobacterales (CRE) and identify the proportion and risk factors for bloodstream infection.Methods:This was a retrospective study conducted at the Department of Clinical Laboratory, Peking University People′s Hospital from January 2018 to December 2021. A total of 4 993 patients underwent rectal swab CRE screening for CRE, of which 137 were found to be positive. Clinical and laboratory data of the positive patients were collected, and the following parameters were analyzed: the positive rate of CRE screening in high-risk population, the species of colonized bacteria, antimicrobial resistance and the risk factors of CRE bloodstream infection in colonized patients. Statistical analysis was performed using SPSS 26.0 software. Univariate analysis was conducted using the chi-square (χ 2) test, while multivariate analysis was performed using binary logistic regression. The results were expressed as relative risk (odds ratio, OR) and 95% confidence interval ( CI). A significance level of 0.05 was considered statistically significant. The drug resistance rate of pathogen was analyzed by WHONET 5.6 software. Results:During the study period, a total of 4 991 patients who underwent rectal swab screening were eligible for inclusion, of which 137 patients were screened positive, resulting in a positive rate of 2.7% (137/4 991). The positive rates were higher in the intensive care ward and hematology ward, with rates of 5.5% (27/493) and 3.3% (109/3 321), respectively. A total of 145 colonization strains were isolated from patients with positive CRE screening, including 63 strains of Klebsiella pneumoniae (43.4%, 63/145), 52 strains of Escherichia coli (35.9%, 52/145), 16 strains of Enterobacter cloacae (11.0%, 16/145) and 14 strains of other Enterobacterales (9.7%, 14/145). The metal β-lactamase production type was the main component of CRE positive colonizing bacteria. The antimicrobial resistance of 145 strains to 22 antibacterial agents revealed that amikacin and tigacycline were the most sensitive. Among 137 CRE screening-positive patients, 14 (10.2%, 14/137) developed bloodstream infection. The isolated pathogenic bacteria included 10 Klebsiella pneumoniae strains and 4 Escherichia coli strains, with a predominant serine carbapenemase producing. Notably, the enzyme type and antimicrobial resistance of the bloodstream infection isolates in the same patient were highly consistent with those of the previous screening strains. Comparison was made between patients with positive CRE screening and those with CRE conversion to bloodstream infection. The unifactor analysis revealed significant differences in surgical history, neutropenia, hematopoietic stem cell transplantation, history of antibiotic use before rectal swab screening, screening within 48 hours after admission, and serine carbapenemase production by strains ( P<0.05). The multivariate analysis indicated that surgical history ( OR 24.659, 95% CI 2.540-239.411, P=0.006) and neutropenia ( OR 93.796, 95% CI 6.294-1 397.804, P=0.001) remained significantly associated with the risk of CRE bloodstream infection ( P<0.05). Conclusions:The CRE colonization rate was low in our hospital, but the proportion of patients with positive screening converted to bloodstream infection was high. Surgical history and neutropenia are risk factors for bloodstream infection transmission. Thus, it is essential to enhance monitoring in high-risk areas and susceptible patients.

Screening and clinical significance of intestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) in patients before haploidentical hematopoietic stem cell transplantation / 中国输血杂志

【Objective】 To investigate the situation of carbapenem-resistant Enterobacteriaceae(CRE) colonization in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT). 【Methods】 A total of 241 consecutive patients who underwent haplo-HSCT in the First Affiliated Hospital of Soochow University from June 1, 2021 to June 1, 2022 were enrolled. Anal swab screening was performed within 48 hours of admission and blood cultures were taken when the patient developed fever. Univariate and multivariate analysis were used to analyze the colonization rate, distribution, risk factors and the correlation between CRE colonization and post-transplant bloodstream infection(BSI). 【Results】 Among 241 patients with haplo-HSCT, there were 90 cases in CRE colonization positive group, with a colonization rate of 37.3% (90/241). Multivariate logistic regression analysis showed that sex (OR 2.42, 95% CI 1.38-4.22, P<0.05) and history of infection within 30 days before transplantation (OR 3.37, 95% CI 1.59-7.17, P<0.05) may be independent risk factors for CRE intestinal colonization. Of the 95 CRE strains, the top five species were carbapenem-resistant Klebsiella pneumoniae (38/95, 40.0%), carbapenem-resistant Escherichia coli (29/95, 30.5%), carbapenem-resistant Enterobacter cloacae (13/95, 13.6%), carbapenem-resistant Klebsiella acidophilus (6/95, 6.3%) and carbapenem-resistant Proteus mirabilis (3/95, 3.1%). The incidence of post-transplant BSI was 12.0% (29/241) in the CRE-colonized group and 3.3% (8/241) in the non-colonized group. In the colonization group, 100% of the pathogens of BSI were identical with those of CRE colonization. 【Conclusion】 Bacterial culture of anal swab during haplo-HSCT is helpful for detection of CRE colonization in intestinal tract, which provides some clinical basis for active monitoring of key flora, prevention and control of infection.