2009～2011年耐碳青霉烯肺炎克雷伯杆菌的流行及整合子分析  

Analysis of the prevalence and integrons distribution of carbapenem-resistant Klebsiella pneumonia (CRKP) in 2009-2010

作　　者：徐艳玲[1] 顾兵 黄茂[1] 刘海燕[1] 梅亚宁 王彤[1] 

机构地区：[1]南京医科大学第一附属医院呼吸科 [2]检验学部,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2013年第4期506-510,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金项目(81000754);江苏省研究生培养创新工程项目(2011-719)

摘　　要：目的:分析2009～2011年南京医科大学第一附属医院分离的耐碳青霉烯类肺炎克雷伯杆菌(CRKP)的流行状况及其携带的整合子的特征、基因盒的种类。方法:细菌鉴定用VITEK2compact全自动鉴定系统或API细菌鉴定系统;细菌药敏试验采用纸片扩散法(K-B法);根据CLSI2012 M100-S22判读结果;聚合酶链反应(PCR)检测Ⅰ、Ⅱ和Ⅲ类整合酶基因及Ⅰ类整合子可变区基因盒。结果:2009～2011年本院耐碳青霉烯类肺炎克雷伯杆菌的分离率显著增高,从1.6%增至11.2%;分离的菌株中对β-内酰胺类药物耐药率均高于95.0%;整合子阳性率为92.6%,均为Ⅰ类整合子,整合子可变区阳性率为78.7%,检测到的基因盒以aadA2最为常见,其次为aacA4-catB8-aadA1及aadA2+dfrA25。结论:本院CRKP的分离率增长迅速,Ⅰ类整合子在CRKP中普遍存在,有较强的从外周捕获耐药基因的能力;建议采取有效措施控制CRKP的传播。Objective：To analyze the prevalence and integrons distribution of carbapenem-resistant Klebsiellapneumonia （CRKP） which isolated at the affiliated hospital of Nanjing Medical University from 2009 to 2010. Methods：All the isolates were identified by VITEK2 compact or API identification system. The antibiotic susceptibility of 81 CRKP was detected by K-B method. Class Ⅰ , Ⅱ and m integrons and their variable regions were detected by PCR. Results：The isolating rate of CRKP increased rapidly from 1.6% in 2009 to 11.2% in 2011. Most of the isolates were resistant to the β-lactams. Among the 81 isolates,92.6% of them are detected of intI1 and 78.7% of the isolates are detected of variable regions. The most common gene cassette is aadA2,followed by the aacA4- catBS-aadA1 and aadA2＋dfrA25. Conclusion：The proportion of C RKP increased rapidly in our hospital and efficient measures should be carried out to inhibit the dissemination of CRKP;Class I integrons are common in the CRKP and the isolates have high capability to capture antibiotic resistance gene cassette.

关 键 词：耐碳青霉烯类肺炎克雷伯杆菌 耐药 整合子 

分 类 号：R378.99[医药卫生—病原生物学]