携带blaKPC-2型碳青霉烯酶基因泛耐药致肺炎克雷伯菌感染的暴发  

Outbreak of Pan-resistant Klebsieila pneumoniae Harboring blaKPC-2 Type Carbapenemase geue in a Hospital in HU Zhou, Zhejiang province

作　　者：黄支密[1] 糜家睿[2] 盛以泉[1] 储秋菊[1] 葛丽卫[1] 邹玉秀[1] 杨海燕[1] 

机构地区：[1]中国人民解放军第98医院检验科,浙江湖州313000 [2]江苏大学临床医学院,江苏镇江212013

出　　处：《世界感染杂志》2010年第1期17-21,共5页World Journal of Infection

摘　　要：目的了解临床分离的泛耐药肺炎克雷伯菌（Klebsiella pneumoniae，Kpn）KPC型碳青霉烯酶基因blaKPC存在状况。方法在2008年11月至2009年7月间，从住院病人中分离出19株泛耐药肺炎克雷伯菌，采用改良Hodge试验检测菌株产碳青霉烯酶情况，采用PCR及序列分析的方法分析blaKPC基因。结果19株泛耐药肺炎克雷伯菌改良Hodge试验结果均阳性、blaKPC基因阳性率为100．0％，序列分析确认均blaKPC-2亚型，其HZ001号菌株（原始编号HZ9871）blaKPC-2基因序列已登录GenBank，注册号为GU086225。结论临床分离的泛耐药肺炎克雷伯菌均携带blaKPC-2基因，产KPC-2型碳青霉烯酶应该是本组菌株对碳青霉烯类抗生素耐药主要原因。Objectives To investigate the presence of genotype of the KPC （Klebsiella pneumoniae Carbapenemase）-encoding genes in Pan-resistant K. pneumoniae isolated from the PLA 98th Hospital, Huzhou District, Zhejiang province, China. Methods 19 strains of Pan-resistant K. pneurnoniae were isolated from the inpatients between November, 2008 and July, 2009. Phenotypic confirmatory test for suspected Carbapenemases production were performed by Modified Hodge test. Carbapenemase gene of blaKPC were analyzed by PCR and confirmed by DNA sequencing. Results In 19 strains of K. pneumoniae, all were positive in Modified Hodge test and blaKPC gene was amplified from all strains. These gene were all the blaKPC.2 subtype confirmed by nucleotide sequence analysis. Among them, the blaKPC-2 gene sequence of the HZ001 strain （its original serial number was HZ9871） has been registered in GenBank （GenBank Accession Number： GU086225）. Conclusions All of the Pan-resistant K. pneumoniae isolated from the inpatients harbored blaKPC-2 type Carbapenemases gene and caused an outbreak in hospital, and the production of KPC-2 type Carbapenemases could be the major cause of resistant to Carbapenems antibiotic.

关 键 词：肺炎克雷伯菌 泛耐药 碳青霉烯酶 耐药基因 

分 类 号：R378.996[医药卫生—病原生物学]