耐碳青霉烯类克雷伯菌耐药性分析  

Drug resistance analysis of carbapenem resistant Klebsiella bacteria

作　　者：蒋子豪 赵永新[1] 苏兵 庞敬莹 王妍妍[1] 朱辉[1] 张铁汉[1] JIANG Zihao;ZHAO Yongxin;SU Bing;PANG Jingying;WANG Yanyan;ZHU Hui;ZHANG Tiehan(Department of Laboratory,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Clinical Medicine,the Sanquan College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院检验科,河南新乡453003 [2]新乡医学院三全学院临床医学院,河南新乡453003

出　　处：《新乡医学院学报》2020年第11期1057-1061,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:2018010017)。

摘　　要：目的研究耐碳青霉烯类克雷伯菌属细菌(CR-Klebsiella)的耐药性和基因型特点,为临床合理用药提供依据。方法收集新乡医学院第三附属医院2016年1月至2019年6月临床分离的CR-Klebsiella 112株,统计其耐药情况。采用改良碳青霉烯酶灭活试验检测菌株耐药表型,聚合酶链式反应检测常见碳青霉烯类耐药基因(KPC、NDM、IMP),多位点序列分型方法分析耐碳青霉烯类肺炎克雷伯菌(CR-KP)菌株间同源性。结果112株CR-Klebsiella中以CR-KP为主(80.36%,90/112),其次为臭鼻克雷伯菌(15.18%,17/112)和产酸克雷伯菌占(4.46%,5/112)。3种CR-Klebsiella对多数β-内酰胺类抗菌药物耐药或者敏感性降低。112株菌株中共有66株产丝氨酸碳青霉烯酶,10株产金属碳青霉烯酶。76株产酶菌株中有73株检测到KPC基因,3株检测到NDM基因,未检测到IMP基因。41株CR-KP克隆分型以ST11型为主,其次是ST15型。结论CR-Klebsiella对常见抗菌药物耐药严重,多数菌株携带相关耐药基因。Objective To investigate the antibiotic resistance characteristics and genotypes of carbapenem resistant Klebsiella bacteria(CR-klebsiella),so as to provide basis for clinical rational drug use.Methods One hundred and twelve CR-Klebsiella strains which were separated in the Third Affiliated Hospital of Xinxiang Medical University from January 2016 to June 2019 were collected,and their antibiotic resistance characteristics were analyzed.The resistant phenotypes of CR-Klebsiella strains were detected by modified carbapenem inactivation method;the common carbapenem resistant gene(KPC,NDM,IMP)was detected by polymerase chain reaction;the homology of carbapenem resistant Klebsiella pneumoniae(CR-KP)strains was analyzed by multilocus sequence typing.Results Among the 112 CR-Klebsiella strains,CR-KP was dominant(80.36%,90/112),followed by Klebsiella odorifera(15.18%,17/112)and Klebsiella acidogenes(4.46%,5/112).Three kinds of CR-Klebsiella were resistant or less sensitive to most of the antibiotics.Among the 112 CR-Klebsiella strains,66 strains were serine carbapenem and 10 strains were metal carbapenem.In 76 enzyme producing strains,KPC gene was detected in 73 strains,NDM gene was detected in 3 strains,but IMP was not detected.The clonal typing of 41 CR-KP strains were mainly ST11,followed by ST15.Conclusion CR-Klebsiella has serious resistance to common antibiotics,a large proportion of the strains carry relevant resistance genes.

关 键 词：克雷伯菌属 耐药性 同源性分析 

分 类 号：R446.5[医药卫生—诊断学]