碳青霉烯耐药肺炎克雷伯菌临床分布及耐药基因检测  

Clinical distribution of carbapenem resistant Klebsiella pneumoniae and its drug resistant gene detection

作　　者：蔡心安 蔡龙啸 闫敏 姚慧琳 CAI Xin′an;CAI Longxiao;YAN Min;YAO Huilin(Department of Clinical Laboratory,the 901 Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army,Hefei,Anhui 230031,China;First Clinical Medical College,Anhui Medical University,Hefei,Anhui 230022,China;Department of Clinical Loboratory,Huaibei Miner General Hospital,Huaibei,Anhui 235000,China)

机构地区：[1]中国人民解放军联勤保障部队901医院检验科,安徽合肥230031 [2]安徽医科大学第一临床医学院,安徽合肥230022 [3]安徽省淮北矿工总医院检验科,安徽淮北235000

出　　处：《检验医学与临床》2020年第12期1662-1665,共4页Laboratory Medicine and Clinic

摘　　要：目的了解中国人民解放军联勤保障部队第901医院2017年全院住院患者碳青霉烯耐药肺炎克雷伯菌(CRKP)检出情况,并对CRKP的耐药基因携带情况进行分析。方法收集中国人民解放军联勤保障部队901医院2017年1月1日至2017年12月31日住院患者临床分离的CRKP,采用PHNX10分析其临床常用抗菌药物的耐药情况,用琼脂稀释法确定每株待测菌的最低抑菌浓度(MIC),用WHONET5.6软件统计分析CRKP的临床分布,并用PCR法扩增碳青霉烯酶基因及其他β-内酰胺酶基因。结果该院2017年住院患者共检出23株CRKP,其中神经外科检出12株,重症监护病房(ICU)检出3株,普外科检出2株,干部病房检出2株,骨科、五官科、眼科、泌尿外科各检出1株;标本类型主要为痰(16例),其次为创面;23株CRKP中21株携带blaKPC-2基因;19株同时携带blaKPC-2、blashv-1基因,2株同时携带blaKPC-2、blashv-1、blactx-m-15基因。结论产blaKPC-2是该院CRKP主要原因,应引起临床重视。Objective To understand the detection status of carbapenem resistant Klebsiella pneumoniae(CRKP)in all inpatients of the 901 Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army in 2017,and analyze the carrying status of resistant genes of CRKP.Methods CRKP clinically isolated from hospitalized patients in the 901 Hospital of the Joint Logistic Support Force of the Chinese People′s Liberation Army from January 1,2017 to December 31,2017 were collected,and the drug resistance of commonly used antimicrobial agents were analyzed by PHNX10.The minimum inhibitory concentration(MIC)of each strain was determined by agar dilution method.The clinical distribution of CRKP was statistically analyzed with WHONET5.6 software.The gene of carbapenem and otherβ-lactamase were amplified by PCR.Results A total of 23 strains of CRKP were detected in the inpatients of the hospital in 2017,including 12 strains in neurosurgery,3 strains in ICU,2 strains in general surgery,2 strains in cadre′s ward,1 strain each in orthopedics,ENT,ophthalmology and urology.The specimens were mainly sputum(16 cases),followed by wound surface.BlaKPC-2 gene was found in 21 of the 23 strains of CRKP,while blaKPC-2,blashv-1 and blactx-m-15 genes were present in 19 strains.Conclusion The main cause of producing blaKPC-2 in the hospital is carbapenem resistant Klebsiella pneumoniae,which should be paid more attention in clinic.

关 键 词：碳青霉烯耐药 肺炎克雷伯菌 基因 Β-内酰胺酶 最低抑菌浓度 

分 类 号：R446.5[医药卫生—诊断学]