亚胺培南耐药大肠埃希菌碳青霉烯酶耐药基因及流行病学的分析  

Analysis of carbapenemase resistance gene and epidemiology in imipenem-resistant escherichia coli

作　　者：姜梅杰[1] 刘丽娟 赵书平[1] JIANG Mei-jie;LIU Li-juan;ZHAO Shu-ping(Taian Central Hospital Laboratory,Jinan 271100,China;Jinan City People’s Hospital Laboratory,Jinan 271100,China)

机构地区：[1]泰安市中心医院检验科,山东济南271100 [2]济南市人民医院检验科,山东济南271100

出　　处：《中国实验诊断学》2022年第6期791-795,共5页Chinese Journal of Laboratory Diagnosis

基　　金：山东省自然科学基金(ZR2016HL44)。

摘　　要：目的 对临床分离的亚胺培南耐药大肠埃希菌(IREC)菌株的分布、碳青霉烯酶耐药基因及分子流行病学特征进行分析,为临床抗菌药物的使用及控制院内感染提供依据。方法 对泰安市中心医院2020年6-12月期间分离到的IREC应用 BD hoenix^(TM)100全自动化微生物细菌分析仪对菌株进行鉴定及药物敏感性分析,PCR法检测碳青霉烯酶耐药基因,mCIM 联合eCIM 试验初筛碳青霉烯酶,多位点序列分型(MLST)和脉冲场琼脂凝胶电泳(PFGE)分析IREC分子流行病学特征。结果 10 株IREC均表现出多重耐药的特性,均携带金属酶基因 bla_(NDM),8 株bla_(NDM-5)、2株bla_(NDM-1)。MLST分子分型共检出3个ST 型,分别为ST405(6/10)、ST167(3/10)、ST131(1/10),ST405是主要的序列类型,其次为ST167。PFGE同源性分析共分为5个克隆群,A、B、C、D、E群,其中6株ST405型菌株均属于 E群。结论 院内IREC耐药性严重,以携带bla_(NDM-5)和_(NDM-1)为主,主要流行于重症医学科和肾内科,尿液标本是其主要来源,E群ST405型大肠埃希氏菌在院内存在播散流行。Objective The distribution of imipenem-resistant escherichia coli(IREC)strains and the resistance genes of Carbapenem and the characteristics of Molecular epidemiology were analyzed to provide evidence for clinical use of antibiotics and hospital-sense control.Methods IREC isolated from our hospital from June to December 2020 were identified by BD hoenix^(TM)100 automatic microbial bacterial analyzer and drug sensitivity test,the carbapenem resistance gene was detected by PCR,the carbapenase was screened by mCIM combined with eCIM test,characterization of imipenem-resistant escherichia coli molecular epidemiology by multilocus sequence typing and pulsed-field agar gel electrophoresis(PFGE).Results All the IREC strains contained bla_(NDM )gene,8 strains carry bla_(NDM-5)and 2 strains carry bla_(NDM-1).The results of mCIM combined with eCIM test were all positive,consistent with PCR results.Three ST types were detected by MLST molecular typing,ST405(6/10),ST167(3/10),and ST131(1/10),respectively.ST405 was the main type,followed by ST167.PFGE homology analysis was divided into 5 clonal groups,group A,B,C,D and E,among which 6 strains ST405 belonged to Group E.All strains showed multiple drug resistance.Conclusion IREC resistance in hospitals is serious,mainly carry bla_(NDM-5)gene and_(NDM-1)gene,most of the isolate strains were separated from ICU and nephrology department,and urine samples are the main source.E-group ST405 e.coli was transmitted in hospital.

关 键 词：耐亚胺培南 大肠埃希菌 碳青霉烯酶 同源性 

分 类 号：R378[医药卫生—病原生物学]