2016—2018年成都某院耐碳青霉烯肺炎克雷伯菌耐药变迁及耐药机制分析  

Analysis of drug resistance changes and drug resistance mechanisms of carbapenemresistant Klebsiella pneumoniae from 2016 to 2018 in a Chengdu hospital

作　　者：王群 叶梅毅 王芳[3] 杨朝国[1] Wang Qun;Ye Mei-yi;Wang Fang;Yang Chao-guo(Chengdu University of Traditional Chinese Medicine,Chengdu 611371;Department of Clinical Laboratory,Dayi County People's Hospital,Chengdu 611330;Department of Clinical Laboratory,Sichuan Traditional Chinese Medicine Hospital,Chengdu 610075)

机构地区：[1]成都中医药大学,成都6111371 [2]大邑县人民医院检验科,成都611330 [3]四川省中医医院检验科,成都610075

出　　处：《中国抗生素杂志》2020年第9期919-923,共5页Chinese Journal of Antibiotics

摘　　要：目的分析2016—2018年四川省中医医院临床分离的耐碳青霉烯肺炎克雷伯菌(carbapenem resistant Klebsiella pneumoniae,CRKP)的耐药性变迁及耐药机制。方法收集本院临床分离的CRKP菌株,PCR扩增碳青霉烯酶基因A类(blaKPC、blaGES、blaSME、blaIMI和blaNMC),B类(blaNDM、blaVIM、blaIMP、blaSPM、blaGIM、blaSIM)和D类(blaOXA)。结果近3年分离的CRKP对临床常用抗生素呈高水平耐药。经PCR扩增及测序确认,74株CRKP中,82.43%携带blaKPC-2型,10.81%携带blaNDM-1型,5.41%携带blaKPC-19型。结论3年间本院分离的CRKP对临床常用抗生素呈高度耐药,菌株产blaKPC-2和blaNDM-1是本院CRKP最主要的耐药机制。Objective To analyze the drug resistance changes and drug resistance mechanisms of clinical isolates of carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from Sichuan Traditional Chinese Medicine Hospital in 2016—2018.Methods To collect clinically isolated CRKP strains in Sichuan Traditional Chinese Medicine Hospital,and amplify the carbapenemase genes including class A(blaKPC,blaGES,blaSME,blaIMI,and blaNMC),class B(blaNDM,blaVIM,blaIMP,blaSPM,blaGIM,and blaSIM),and class D(blaOXA)by polymerase chain reaction(PCR).Results The CRKP strains isolated in the past three years were highly resistant to clinical commonly used antibiotics.According to PCR amplification and sequencing,61 strains(82.43%)carried blaKPC-2 gene,8 strains(10.81%)carried blaNDM-1 gene,and 4 strains(5.41%)carried blaKPC-19 gene.Conclusion In the past 3 years,CRKP strains isolated in Sichuan Traditional Chinese Medicine Hospital were highly resistant to clinically used antibiotics.Strains producing the carbapenemase gene blaKPC-2 and blaNDM-1 were the most important resistance mechanisms in this hospital.

关 键 词：肺炎克雷伯菌 碳青霉烯酶 耐药性 耐药机制 

分 类 号：R446.5[医药卫生—诊断学] R9[医药卫生—临床医学]