携带blaKPC-2型碳青霉烯酶基因泛耐药肺炎克雷伯菌医院内感染暴发的病原学分析  

Study on pan-resistant Klebsiella pneumoniae harboring blanc-2 type carbapenemase gene from a hospital outbreak in Huzhou, Zhejiang

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

机构地区：[1]解放军第98医院检验科,湖州313000 [2]江苏大学临床医学院

出　　处：《中华流行病学杂志》2010年第5期559-562,共4页Chinese Journal of Epidemiology

摘　　要：目的了解引起医院内感染暴发临床分离的泛耐药肺炎克雷伯菌（Kpn）KPC型碳青霉烯酶基因blaKPC存在状况。方法2008年11月至2009年7月从住院患者中分离19株泛耐药Xpn，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Kpn改良Hodge试验结果均阳性、blaKPC基因阳性率为100．0％，序列分析确认均为blaKPC-2亚型，其中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Kpn均携带blaKPC-2基因，而产KPC-2型碳青霉烯酶是分离菌株对碳青霉烯类抗生素耐药的主要原因。Objective To investigate the status of genotype of the KPC （Klebsiella pneumoniae carbapenemase）-encoding genes in Pan-resistant K. Pneumoniae, isolated from the 98th Hospital of People＇ s Liberation Army, Huzhou district, Zhejiang province, China. Methods 19 strains of Pan-resistant K. pneumoniae were isolated from the inpatients between November, 2008 and July, 2009. Phenotypic confirmatory test for suspected carbapenemases production were carried out by Modified Hodge test. Carbapenemase gene of blaKPC was analyzed by PCR and verified by DNA sequencing. Results In 19 strains of K. pneumoniae, the positive rates of Modified Hodge test and gene of blaKPC were both 100.0%. These genes all belonged to 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） had been registered in GenBank （GenBank Accession Number： GU086225）. Conclusion All of the Pan-resistant K. pneumoniae isolated from the inpatients harbored blaKPC-2 type carbapenemases gene and causing an outbreak in a hospital. Carbapenemases that producing type KPC-2 might be the major reason which causing the resistance to Carbapenems antibiotics.

关 键 词：肺炎克雷伯菌 泛耐药 碳青霉烯酶 耐药基因 

分 类 号：R446.5[医药卫生—诊断学]