碳青霉烯类耐药肺炎克雷伯菌ERIC-PCR指纹图谱分型的研究  

A Study on ERIC-PCR Finger Printing Typing of Carbapenems-resistant Klebsiella Pneumoniae

作　　者：李睿[1] 辛力华[1] 张青[1] 张琼芳[1] 王芳[1] 任然[1] 熊大迁[1] LI Rui;XIN Li-hua;ZHANG Qing;ZHANG Qiong-fang;WANG Fang;REN Ran;XIONG Da-qian(Department of Clinical Laboratory,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学附属医院检验科,成都610075

出　　处：《解放军医药杂志》2018年第11期102-105,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省卫生和计划生育委员会科研课题(18PJ105);成都中医药大学院基金(2017-D-YY-3)

摘　　要：目的探究碳青霉烯类耐药肺炎克雷伯菌(KPC)的ERIC-PCR指纹图谱分型。方法收集成都中医药大学2016年7月—2017年4月临床标本中分离出的KPC31株,行药敏试验、改良Hodge试验,并采用PCR检测碳青霉烯酶基因;阳性结果行DNA测序,并与BLAST比对确定基因型,以肠杆菌科基因间重复序列(ERIC-PCR)行同源性分析。结果31株KPC主要来源于重症监护室;所测KPC菌株对β-内酰胺类药物100%耐药,仅部分菌株对四环素、庆大霉素、阿米卡星、复方新诺明表现敏感,敏感率分别为3.23%、9.68%、90.32%、67.74%;改良Hodge试验显示29株KPC均为阳性;DNA测序及PCR扩增证实bla_(KPC-2)基因型30株;bla_(IMP-1)基因型1株;ERIC-PCR同源性分析发现KPCA1型30株及A2型1株。结论bla_(KPC-2)是导致KPC产生的主要分型,且A1型已在我院流行,应引起临床重视,加强院感监控及预防。ERIC-PCR是一种适合于做同源性分型筛查的简便快捷的初步基因分型技术。Objective To investigate ERIC-PCR finger printing typing of Carbapenems-resistant klebsiella pneumoniae （KPC）. Methods A total of 31 strains of KPC isolated from clinical specimens during July 2016 and April 2017 were recruited in this study, and then drug susceptibility test and modified Hodge test were performed, and polymerase chain reaction （PCR） was used to detect carbapenem gene. Positive results were given DNA sequencing, and were compared with BLAST to identify genotypes, and homology analysis was performed by using enterobacteriaceae repetitive intergenic consensus-polymerase chain reaction （ERIC-PCR）. Results The 31 strains of KPC were mainly from Intensive Care Unit. The measured KPC strains were 100% resistant to β-lactam drugs, and some strains were sensitive to Tetracycline, Gentamycin, Amikacin and Compound Sulfamethoxazole, and sensitivity rates were 3.23%, 9.68%, 90.32% and 67.74% respectively. Modified Hodge test showed that 29 KPC strains were positive. DNA sequencing and PCR amplification tests confirmed that 30 strains were bla KPC-2 genotype, and 1 strain was bla IMP-1 genotype. ERC-PCR homology analysis showed that there were 30 strains of KPCA1 type and 1 strain of KPCA2 type. Conclusion The bla KPC-2 type is the main type induced KPC production, and A1 type has already been popular in our hospital, and therefore it should be pay more attention to strengthen monitoring and prevention of nosocomial infection. ERIC-PCR is an easily and quickly preliminary genotyping technique for homologous typing screening.

关 键 词：肺炎克雷伯菌 碳青霉烯类 耐药性 肠杆菌科基因间重复序列 基因型 

分 类 号：R378.99[医药卫生—病原生物学]