区域性耐碳青霉烯类抗生素肺炎克雷伯菌耐药基因型的分析  

Analysis of Resistance Genotypes of Carbapenem Resistant Klebsiella Pneumoniae to Regional Carbapenem Antibiotics

作　　者：佟忠山[1] 尤玉红[1] 姜月红[1] 杜英[1] 杜巍[1] 孙磊[1] TONG Zhong-shan;YOU Yu-hong;JIANG Yue-hong(Department of Laboratory Medicine,Heilongjang Provincial Hospital,Harbin,Heilongjiang,150001,China)

机构地区：[1]黑龙江省医院检验科,黑龙江哈尔滨150001

出　　处：《黑龙江医学》2021年第19期2051-2053,共3页Heilongjiang Medical Journal

基　　金：黑龙江省卫生计生委科研课题(2017-460)。

摘　　要：目的:分析区域耐碳青霉烯类抗生素肺炎克雷伯菌(carbapenem resistant Klebsiella pneumoniae,CR-KPN)的耐药性及耐药基因型。方法:筛选黑龙江省医院2018年1月—2020年12月临床分离的菌株,通过BD Phoenix~(TM)-100全自动细菌鉴定、药敏系统细菌鉴定和药敏试验,改良碳青霉烯灭活试验(mCIM)表型筛查CR-KPN36株,分析CR-KPN的临床分布特点、耐药特性及耐药基因型。结果:医院分离的CR-KPN主要来源于神经外科、ICU、康复科等,除氨基糖苷类和四环素类抗生素有一定抑制作用外,一、二、三、四代头孢菌素和碳青霉素类抗生素等β-内酰胺类抗生素耐药率接近100%,主要携带blaKPC基因型(97.22%)。结论:CR-KPN临床检出逐年增加,其耐药性强,临床抗感染难道大,需加强病原菌监测,并进行耐药基因检测,指导区域临床合理使用抗菌药物,做好院感防控。Objective:To analyze the drug resistances and the genomic subtyping of carbapenem resistant Klebsiella pneumoniae(CR-KPN).Methods:The strains isolated clinically in the hospital from January 2018 to December 2020 were screened.Through the BD PhoenixTM-100 automatic bacterial identification/drug susceptibility system,bacterial identification and drug susceptibility testing,the carbapenem inactivation test(mCIM)phenotypic screening CR-KPN36 strain was improved.The clinical distribution characteristics,resistance characteristics and resistance genotypes of CR-KPN were analyzed.Results:The CR-KPN separated from the hospital mainly came from neurosurgery,ICU,rehabilitation department,etc.Except aminoglycosides and tetracycline antibiotics had a certain inhibitory effect,the resistance rate ofβ-lactam antibiotics such as first,second,third and fourth generation cephalosporins and carbapenicillins was close to 100%,mainly carried blaKPC genotype(97.22%).Conclusion:The clinical detection of CR-KPN is increasing year by year.Its drug resistance is strong,and the clinical anti-infection is difficult.It is necessary to strengthen the surveillance of pathogenic bacteria and conduct drug resistance gene detection.Regional clinical antibacterial drugs are used rationally,and nosocomial infection prevention and control are carried out.

关 键 词：耐碳青霉烯类抗生素肺炎克雷伯菌 耐药性 耐药基因 

分 类 号：R965.2[医药卫生—药理学]