产ESBLs肺炎克雷伯菌药敏性和耐药基因表型分析  

Analysis of drug sensitivity and drug resistance gene phenotype of ESBLs-producing Klebsiella pneumoniae

作　　者：邓明惠 候轩[1] 张微[1] 王辉[1] 辜依海[1] DENG Minghui;HOU Xuan;ZHANG Wei;WANG Hui;GU Yihai(Department of Clinical Laboratory,3201 Hospital Affiliated to Medical College of Xi′an Jiaotong University,Hanzhong,Shannxi 723000,China)

机构地区：[1]西安交通大学医学院附属三二〇一医院检验科,陕西汉中723000

出　　处：《国际检验医学杂志》2020年第16期1994-1998,共5页International Journal of Laboratory Medicine

摘　　要：目的研究社区获得性感染及医院获得性感染产超广谱-β内酰胺酶(ESBLs)肺炎克雷伯菌菌株药敏性和耐药基因表型,为有效地控制感染的流行提供依据。方法收集2016年1月至2018年6月该院81株产ESBLs肺炎克雷伯菌,并根据菌株来源情况将所有菌株分为社区获得性感染和医院获得性感染两组。采用纸片扩散法检测81株肺炎克雷伯菌菌株对21种常用抗菌药物的耐药性;并通过ESBLs确认试验检测所有菌株是否产ESBLs;通过PCR扩增测序检测ESBLs耐药基因。结果44株社区获得性感染菌和37株医院获得性感染菌进行药敏性比较,差异无统计学意义(P>0.05);社区获得性感染菌TEM、SHV、CTX-M-9基因表型中阳性株均多于医院获得性感染菌,在耐药基因阳性株的比例上,CTX-M-9在社区获得性感染菌中的携带率高于医院获得性感染菌的携带率,差异有统计学意义(P<0.05),其他的ESBLs基因型,如CTX-M-1、SHV、TEM基因型比较,差异均无统计学意义(P>0.05)。结论无论是菌株的耐药率,还是ESBLs耐药基因的携带率,社区获得性感染菌与医院获得性感染菌均比较接近。Objective To study drug susceptibility and drug resistance gene phenotype of community-acquired and hospital-acquired ESBLs-producing Klebsiella pneumoniae strains,so as to provide evidence for effective control of the epidemic of infection.Methods A total of 81 strains ESBLs-producing Klebsiella pneumoniae from 3201 Hospital Affiliated to Medical College of Xi′an Jiaotong University from January 2016 to June 2018 were collected,and all strains were divided into two groups including community-acquired infection group and hospital-acquired infection group according to the source of the strain.The paper diffusion method was used to detect the resistance of Klebsiella pneumoniae strains to 21 kinds of commonly used antibacterial drugs,and the ESBLs confirmation test was used to detect whether all strains produced ESBLs.PCR amplification sequencing was used to detect ESBLs genotypes.Results The drug sensitivity of 44 community-acquired strains and 37 hospital-acquired strains had no significant difference(P>0.05).The carrying rate of TEM,SHV,CTX-M-9 genotype of community-acquired strains were more than hospital-acquired strains,and the carrying rate of CTX-M-9 in community-acquired strains was higher than that of hospital-acquired strains(P<0.05).However,there was no significant difference in other ESBLs genotypes,such as CTX-M-1,SHV and TEM genotypes(P>0.05).Conclusion Whether the drug resistance rate of strains or the carrying rate of ESBLs resistance genes,community-acquired strains are close to hospital-acquired strains,providing experimental basis for clinical and effective measures to further control the epidemic and transmission of ESBLs-producing Klebsiella pneumoniae.

关 键 词：肺炎克雷伯菌 药敏性 耐药基因表型 

分 类 号：R446.5[医药卫生—诊断学]