2015-2019年上海市普陀区急性呼吸道感染肺炎克雷伯菌的耐药监测及分子特征  

Drug resistance surveillance and molecular characteristics of Klebsiella pneumoniae from acute respiratory tract infection from 2015 to 2019 in Putuo District,Shanghai

作　　者：胡焰 李晓君[1] 唐海丰[1] 顾文超[1] 何鑫[1] 张焕生[1] HU Yan;LI Xiao-jun;TANG Hai-feng;GU Wen-chao;HE Xin;ZHANG Huan-sheng(Putuo Center for Disease Control and Prevention,Shanghai 200333,China)

机构地区：[1]上海市普陀区疾病预防控制中心,上海200333

出　　处：《现代预防医学》2021年第10期1896-1900,共5页Modern Preventive Medicine

基　　金：上海市普陀区卫健委公共卫生青年项目。

摘　　要：目的了解上海市普陀区急性呼吸道感染肺炎克雷伯菌的耐药谱系,研究其分子同源性及进化情况。方法收集2015-2019年普陀区急性呼吸道综合监测哨点医院呼吸道样本分离的肺炎克雷伯菌进行菌株鉴定和药敏试验,对耐药菌株进行多位点序列分析(multilocus sequence typing,MLST)及统计分析,得出结论。结果 131株肺炎克雷伯菌中36株出现耐药,占35.11%,其中23株对两类以上药物耐药,占17.56%,1株菌为泛耐药菌株。131株肺炎克雷伯菌对碳青霉烯类和头孢类抗生素耐药率最高,对喹诺酮类、氨基糖苷类、磺胺类和复方制剂等都有不同程度的耐药。对两类以上耐药的23株菌进行MLST分析,分为16个ST型,其中ST23为5株,ST65、ST268和ST375各2株,ST11、ST14、ST25、ST86、ST202、ST218、ST380、ST412、ST882、ST1333、ST1764和ST2165各1株。结论普陀区急性呼吸道感染肺炎克雷伯菌存在较明显的耐药,以ST23型为主,型别多样化,应加强呼吸道细菌耐药监测并指导临床严格规范抗生素用药。Objective To understand the drug resistance spectrum of Klebsiella pneumoniae in acute respiratory tract infection in Putuo District of Shanghai,and to study its molecular homology and evolution.Methods A total of 131 strains of Klebsiella pneumoniae isolated from respiratory tract bacterial samples of sentinel hospital of Putuo District from 2016 to 2019 were identified and tested for drug sensitivity.Multi-locus sequence typing(MLST)analysis was performed for drugresistant strains,and the results were statistically analyzed.Results In total 36 of the 131 strains were resistant,accounting for 35.11%,of which 23 strains(17.56%)were resistant to more than two classes of drugs,and one strain was pan-resistant.The 131 strains of Klebsiella pneumoniae had the highest resistance rate to carbapenems and cephalosporins and varied degrees of resistance to quinolones,aminoglycosides,sulfonamides and combination agents.MLST analysis was performed on 23 strains with more than two types of resistance,which were classified into 16 ST types.There were 5 strains of ST23,2 strains of ST65,2 strains of ST268 and ST375,1 strain of ST11,ST14,ST25,ST86,ST202,ST218,ST380,ST412,ST882,ST1333,ST1764 and ST2165.Conclusion Acute respiratory tract infection Klebsiella pneumoniae in Putuo District has obvious drug resistance,mainly ST23 type and diversified types.The monitoring of respiratory tract bacterial drug resistance and guide the clinical strict regulation of antibiotic use should be strengthened.

关 键 词：急性呼吸道感染 肺炎克雷伯菌 多位点序列分析 耐药 

分 类 号：R183.3[医药卫生—流行病学] R115[医药卫生—公共卫生与预防医学]