首例同时携带bla_(NDM-1)、bla_(KPC-2)、bla_(DHA-1)、bla_(TEM-1)和bla_(OXA-1)基因的ST11肺炎克雷伯菌临床株  

Coexistence of bla_(NDM-1)、bla_(KPC-2)、bla_(DHA-1)、bla_(TEM-1) and bla_(OXA-1) genes in a clinical ST11 Klebsiella pneumoniae isolate in china

作　　者：油丽萍 陈爱文[2] 秦萍[2] 徐茶 赵辉[1] 吴春梅[1] 朱元祺[2] 

机构地区：[1]青岛大学医学院,山东青岛266071 [2]青岛大学附属医院,山东青岛266003

出　　处：《中国实验诊断学》2015年第5期744-747,共4页Chinese Journal of Laboratory Diagnosis

基　　金：青岛经济技术开发区重点科技发展项目(2013-1-82)

摘　　要：目的探讨产碳青霉烯酶肺炎克雷伯菌的耐药机制,为医院感染控制提供依据。方法法国VITEK-2Compact对细菌进行鉴定和药敏试验;改良Hodge试验初筛肺炎克雷伯菌是否产碳青霉烯酶;多重PCR对菌株进行β-内酰胺类耐药基因和16SrRNA甲基化酶基因的检测,测序确认基因型;多位点序列分型和脉冲场凝胶电泳实验进行细菌的同源性分析。结果 5株肺炎克雷伯菌多位点序列分型是ST11型,其中4株都同时携带有blaKPC-2、blaTEM-1、blaCTXG9和16SrRNA甲基化酶rmtB基因,另外1株(HD03)肺炎克雷伯菌同时携带blaNDM-1、blaKPC-2、blaDHA-1、blaTEM-1和blaOXA-1基因。脉冲场凝胶电泳显示,除了HD04菌株多一条带外,其余带型5株菌完全一致。结论经检索,肺炎克雷伯菌同时携带blaNDM-1、blaKPC-2、blaDHA-1、blaTEM-1和blaOXA-1基因为国内外首次报道,且该感染者无国外流行病学史。因此,要进一步加强对碳青霉烯类耐药的肠杆菌的医院感染控制和预防。Objective To explore the molecular mechanism of the clinical carbapenem-resistant Klebsiella pneumoniae isolates.Methods The strains identification and antibiotic susceptibilities were performed by VITEK-2 compact system.The genes of AmpC,ESBLs,MBL and KPCβ-lactamases were screened by specific PCR.And genotypes were confirmed by DNA sequencing.PFGE and multilocus sequence typing （MLST）were performed.Results 5 Klebsiella pneumoniae isolates were resistant to all antibiotics tested.Genotyping（PFGE）clustered 5 K .pneumoniae isolates into a single clonal type and MLST assigned them to sequence type 11.The blaKPC-2 ,baTEM-1 ,blaCTXG 9 and rmtB genes were present in four isolates.And Molecular testing verified the presence of blaNDM-1 ,blaKPC-2 ,blaDHA-1 ,blaTEM-1 and blaOXA-1 genes in a Klebsiella pneumoniae isolate.Conclusion To our knowledge,this is first report of coexistence of blaNDM-1 , blaKPC-2 ,blaDHA-1 ,blaTEM-1 and blaOXA-1 genes in a clinical Klebsiella pneumonia isolate.It may herald the emergence of a new pattern of drug resistance.Surveillance of metallo-β-lactamases in enterobacteriaceae is urgently needed to control and prevent the spread of these isolates.

关 键 词：肺炎克雷伯菌 基因 blaNDM-1 blaKPC-2 ST11 

分 类 号：R446.5[医药卫生—诊断学]