多药耐药肺炎克雷伯菌β-内酰胺类耐药机制研究  

Investigation of resistant mechanism to β-lactams in multidrug-resistant strains of Klebsiella pneumoniae

作　　者：朱健铭 刘国庆[1] 姜如金[1] 吴康乐[1] 马兆龙[1] 

机构地区：[1]杭州市余杭区中医院检验科,浙江杭州311106

出　　处：《中华医院感染学杂志》2012年第4期674-678,共5页Chinese Journal of Nosocomiology

基　　金：杭州市科技发展计划项目(20110833B48);杭州市卫生科技计划项目(2010B078);杭州市余杭区重大科技项目(2010001)

摘　　要：目的调查多药耐药肺炎克雷伯菌中β-内酰胺酶基因的存在情况。方法收集2010年3-5月浙江大学附属第一医院住院患者标本中分离的多药耐药肺炎克雷伯菌共15株,先做β-内酰胺酶分型,再做改良Hodge试验检测产碳青霉烯酶表型,然后采用聚合酶链反应(PCR)的方法分析40种β-内酰胺酶基因。结果 15株多药耐药肺炎克雷伯菌共检出TEM-1 12株、KPC-2 9株、KPC-2-like 2株、OXA-30 1株,检出率分别为80.00%、60.00%、13.33%、6.67%,2号株与6号株KPC基因为KPC新的变异型(KPC-2-like,GenBank登录号:HQ258934);其他基因均未检出。结论该组15株多药耐药肺炎克雷伯菌耐β-内酰胺类药物与细菌产4种β-内酰胺基因相关。OBJECTIVE To investigate the distribution of β-lactamases in multidrug-resistant Klebsiella pneumoniae（K.pneumoniae）.METHODS Fifteen strains of K.pneumoniae isolated from inpatients of the First Affiliated Hospital of Zhejiang University between Mar.2010 and May 2010 were collected.Typing of β-lactamases was performed first,and then Modified Hodge Test was carried out to detect phenotypes of carbapenemase.Moreover,40 kinds of β-lactamases were analyzed by PCR.RESULTS In 15 strains of multidrug-resistant K.pneumoniae,12 strains（80.00%）,9 strains（60.00%）,2 strains（13.33%） and 1 strain（6.67%） were detected to carry TEM-1,KPC-2,KPC-2-like and OXA-30.Strain 2 and Strain 6 carried new mutants of K.pneumoniae Carbapenemase（KPC-2-like,GenBank accession number：HQ258934）.However,the rest kinds of genes couldn′t be detected.CONCLUSION Four kinds of β-lactamases may play a role in resistance to β-lactams in these 15 strains of multidrug-resistant K.pneumoniae.

关 键 词：肺炎克雷伯菌 Β-内酰胺酶基因 Β-内酰胺类 多药耐药 

分 类 号：R378.996[医药卫生—病原生物学]