山西省某医院发现的携带碳青霉烯酶基因的肺炎克雷伯菌的流行特征研究(英文)  

Characterization and prevalence of Klebsiellapneumonia carrying the carbapenemase gene in a hospital in Shanxi Province,China

作　　者：庞慧[1,2,3] 弓艳娥[4] 袁敏[2,5] 蒋毅[2,5] 郭步平[4] 龚林[2] 李水仙[1] 李娟[2,5] 万康林[2,5] 

机构地区：[1]长治医学院免疫学教研室,长治046000 [2]中国疾病预防控制中心传染病预防控制所/传染病预防控制国家重点实验室,北京102206 [3]中南大学湘雅医学院免疫学系,长沙410078 [4]长治医学院附属和平医院检验科,长治046000 [5]杭州传染病诊疗协同创新中心,杭州310000

出　　处：《中国人兽共患病学报》2014年第11期1110-1115,共6页Chinese Journal of Zoonoses

基　　金：Funded by the projects of Chinese National Key Program of Mega Infectious Disease of the National 12th Five-Year Plan(Nos.2013ZX10003002-001 and 2013ZX10004217)~~

摘　　要：目的肺炎克雷伯菌是一类重要的引起院内感染的病原微生物,可导致机体多个器官和组织受累。本研究主要是针对携带有碳青霉烯酶基因的肺炎克雷伯菌进行分子特征和流行状况的评价。方法本研究中所用菌株是2008-2012年分离自山西省长治某医院的标本,通过琼脂扩散和E纸条试验来分析菌株的药敏状况。碳青霉烯酶的产生情况经Carba NP试验来确认,而碳青霉烯酶基因的测定及确证由PCR和DNA测序完成。最后,将碳青霉烯类抗生素耐药菌株进行脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)研究。结果 1 297株临床分离的肺炎克雷伯菌中,有9株对碳青霉烯类抗生素的耐药株,它们都是产A组碳青霉烯酶、肺炎克雷伯菌的碳青霉烯酶(KPC-2)基因阳性,而其它的检测基因均为阴性。尽管9株菌都属于MLST中的ST11型,但就PFGE分析发现,可能存在两次院内感染的传播:分别在2010和2012年。结论携带KPC-2基因的耐药肺炎克雷伯菌已经在医院内传播,加强院内严密监控和制定严格的感染控制措施已是刻不容缓。Klebsiella pneumonia （K.pneumonia） is one of the most common nosocomial pathogens and can cause severe infections in diverse organs and tissues of human body.To assess the characterization and prevalence of K.pneumonia carrying carbapenemase genes,K.pneumonia strains were isolated from a hospital in Changzhi,Shanxi Province,China,between 2008 and 2012.The drug susceptibility test （DST） of the isolates was determined by the agar disc diffusion and E-test.Carba NP test was performed to confirm the production of carbapenemases.The known carbapenemase genes were screened by PCR and DNA sequencing.Carbapenem resistant strains were analyzed by pulsed field gel electrophoresis （PFGE） and multilocus sequence typing （MLST）.A total of 9 （0.69％） resistant strains from 1 297 clinical K.pneumonia isolates engendered group A carbapenemase and demonstrated K.pneumonia carbapenemase gene positive,while carbapenemase genes were all negative among the remaining isolates.MLST confirmed that all of the 9 strains belonged to ST11 genotype.Moreover,by means of PFGE patterns analysis,it could be concluded that there might be two transmissions by the resistant K.pneumonia carrying carbapenemase gene in the hospital,in which one was in 2010 and the other was in 2012.Intensive surveillance and strict infection control policy should be carried out in this area of China.

关 键 词：肺炎克雷伯菌 碳青霉烯酶 药物敏感性试验 脉冲场凝胶电泳 多位点序列分型 

分 类 号：R378.99[医药卫生—病原生物学]