2017年 · 第40卷第05期

Neonatal genetic metabolic disease screening (hereinafter referred to as "new screening") refers to the group screening of some serious congenital metabolic diseases and endocrine diseases through blood tests, so that children can be diagnosed and treated early, and avoid growth, intellectual development disabilities and even death due to brain, liver, kidney and other organ damage. The complete process of new screening management includes systematic engineering integrating obtaining informed consent of screening subjects, sample collection and delivery, sample testing and re-examination, disease diagnosis and classification, treatment and follow-up^[1,2]。 The whole work process is complicated, with many organizations and personnel involved. It is urgent to standardize the new screening process, evaluate the quality of each link in the process, and carry out homogeneous management in different regions^[3,4]。 In view of this, according to the management requirements of inter-laboratory quality evaluation in the clinical laboratory of the National Health and Family Planning Commission, the national expert group of new screening experiments formulated 16 new screening quality control indicators after seven rounds of discussion and revision for 1 1/2 years, so as to urge all screening laboratories to strengthen quality management and provide homogeneous new screening services^[5,6,7,8]The specific indicators and interpretations are as follows.

Enterobacter cloacae is an important pathogen of nosocomial infection, which often causes respiratory tract infection, surgical site infection, urinary tract infection, sepsis and outbreak infection in neonatal room^[1]。 The main resistance mechanism of clinically isolated Enterobacter cloacae to carbapenem antibiotics is carbapenemase production^[2]。 Plasmids are closed circular double-stranded DNA molecules that are independent of the chromosome and can replicate themselves. They play an important role in the transmission of drug resistance genes. At present, it has been reported that the New Delhi metallo-beta-lactamase 1 (NDM-1) gene is located on the plasmid, but most of these findings are concentrated on Klebsiella pneumoniae^[3]Escherichia coli^[4]And Acinetobacter baumannii^[5], Enterobacter cloacae has been studied relatively sparsely. It is still unclear whether NDM-1 gene in carbapenem-resistant Enterobacter cloacae is transmitted by plasmid. Therefore, this study intends to conduct a mapping study on NDM-1 gene of seven strains of NDM-1 gene-positive Enterobacter cloacae collected from the First Affiliated Hospital of Kunming Medical University, and to determine whether NDM-1 gene in these strains is transferred horizontally by plasmid.