携带blaKPC-2型耐药基因肺炎克雷伯菌的流行克隆研究  

Study of epidemic clone of Klebsiella pneumoniae carrying blaKPC-2 gene

作　　者：肖士林 陈东科[2] 秦天[1] 周海健[1] 任红宇[1] XIAO Shi-lin;CHEN Dong-ke;QIN Tian;ZHOU Hai-jian;REN Hong-yu(State Key Laboratory for Infectious Disease Prevention and Control,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]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 [2]北京医院检验科国家老年医学中心,北京100730

出　　处：《中华医院感染学杂志》2020年第1期1-5,共5页Chinese Journal of Nosocomiology

基　　金：“十三五”国家科技重大专项基金资助项目(2018ZX10714-002)。

摘　　要：目的揭示我国携带blaKPC-2型耐药基因肺炎克雷伯菌的流行克隆特征,并与国外菌株进行比较。方法对2012-2017年全国40个城市的61家医院分离的100株携带blaKPC-2型耐药基因肺炎克雷伯菌进行多位点序列分型(MLST);通过检索文献获取国外携带blaKPC-2型耐药基因肺炎克雷伯菌MLST数据;使用BioNumerics构建最小生成树。结果 100株携带blaKPC-2型耐药基因肺炎克雷伯菌被分为14个ST型。优势型别为ST11型,包含分离自38个城市的77株菌;其次为ST15型,包含分离自6个城市的7株菌;其余12个型别为ST147、ST1、ST65、ST23、ST25、ST37、ST258、ST395、ST412、ST449、ST502、ST685型,分别包含菌株1-3株。检索文献显示,欧美分离株的优势型别是ST258。结论自2007年我国第一次报道ST11型携带blaKPC-2型耐药基因肺炎克雷伯菌以来,ST11型菌株持续作为优势克隆群,并已扩散至全国大部分地区。应加强该类菌株的分子分型实验室监测,获得系统全面的数据揭示其流行规律,制定针对性防控措施控制其传播。OBJECTIVE To reveal the epidemic cloning characteristics of Klebsiella pneumoniae strains carrying blaKPC-2 gene that were isolated from China and compare them with strains isolated abroad. METHODS The multilocus sequence typing(MLST) was carried out for 100 strains of K. pneumoniae carrying blaKPC-2 that were isolated from 61 hospitals in 41 cities of China from 2012 to 2017, the foreign MLST data of K. pneumoniae strains carrying blaKPC-2 gene were obtained by means of literature retrieval, and the minimum spanning trees were constructed by using BioNumerics software. RESULTS The 100 strains of K. pneumoniae carrying blaKPC-2 gene were divided into 14 MLST types(STs).The dominant type was ST11, which contained 77 strains isolated from 38 cities;the next was ST15, which contained 7 strains isolated from 6 cities;the rest of 12 types were ST147, ST1, ST65, ST23, ST25, ST37, ST258, ST395, ST412, ST449, ST502 and ST685, which contained 1-3 strains respectively.The retrieved literatures showed that the dominant type of the European and American isolates was ST258.CONCLUSION As the dominant clone, ST11 type strains had spread to most areas of the country since the ST11 K. pneumoniae carrying blaKPC-2 was first reported in China in 2007.It is necessary to strengthen the laboratory monitoring of molecular subtypes of the strains so as to obtain systematic and comprehensive data to reveal the epidemic laws and put forward targeted prevention measures.

关 键 词：肺炎克雷伯菌 多位点序列分型 blaKPC-2耐药基因 流行克隆 防控 

分 类 号：R378.996[医药卫生—病原生物学]