广东省东莞地区发现1株泛耐药产KPC-2型碳青霉烯酶的肺炎克雷伯菌  

A strain of extensively drug resistant and KPC-2 carbapenemase-producing Klebsiella pneumoniae is identified in Dongguan,Guangdong province

作　　者：张丽[1] 张小兵[1] 杨维青[1] 黄娟[1] 张丽华[1] 张菊芬[1] 朱学海[1] 朱凯欣[1] 周静[1] 

机构地区：[1]中山大学附属东华医院检验科细菌室,广东东莞523110

出　　处：《中国感染与化疗杂志》2013年第6期465-468,共4页Chinese Journal of Infection and Chemotherapy

基　　金：广东省东莞市科技局项目(201110515046224)

摘　　要：目的研究泛耐药肺炎克雷伯菌的相关耐药机制和治疗对策。方法细菌鉴定采用VITEK2全自动细菌鉴定系统,药敏试验采用K-B法,通过产碳青霉烯酶确证试验(改良Hodge试验)及聚合酶链反应(PCR)检测KPC-2基因,并进行序列测定。同时调查感染患者的诊疗情况。结果常规药敏试验显示,该菌株对阿米卡星敏感,对其他抗菌药物均耐药;Hodge试验阳性,PCR检测到KPC-2基因,序列测定与GenBank 11844849序列一致。患者经拔除气管插管,入住隔离病房,加强支持治疗后,1个月内未检测到泛耐药肺炎克雷伯菌。结论加强泛耐药肺炎克雷伯菌监测,提高对泛耐药菌的认识有助于感染疾病的治疗和预防。Objective To explore the extensively drug resistant mechanism and clinical treatment strategy of t（lebsiella pneu moniae. Methods The isolate was identified by Vitek2 Compact System. Antimicrobial susceptibility testing was conducted by Kirhy-Bauer method. KPC-2 carbapenemase was detected by modified Hodge test. The gene encoding KPC-2 carbapenemase was amplified by polymerase chain reaction （PCR） and then sequenced. Results The strain was resistant to all antibiotics used in routine antimicrobial susceptibility testing except amikacin. Modified Hodge test showed positive result. KPC-2 gene was detected by PCR. The sequence was consistent with that of 11844849 in GenBank. After treatment for one month, no exten sively drug resistant K. pneurnoniae strain was detected from the patient. Conclusions It is necessary to strengthen the monito- ring and improve the awareness of extensively drug resistant K. pneumoniae for better control of such infections

关 键 词：泛耐药 KPC-2碳青霉烯酶 肺炎克雷伯菌 

分 类 号：R446.5[医药卫生—诊断学]