宁波地区临床分离CRKP中mcr基因分布及常用黏菌素敏感差异性分析  

Analysis of mcr gene distribution and colistin sensitivity difference in clinical isolated carbapenem-resistant Klebsiella pneumoniae in Ningbo

作　　者：卢雯君[1] 吴巧萍[2] 李情操[2] 裘雪丹 赵玉杰[2] 乐景阳 LU Wen-jun;WU Qiao-ping;LI Qing-cao;QIU Xue-dan;ZHAO Yu-jie;LE Jing-yang(ICU,Ningbo Medical Center Lihuili Hospital,Zhejiang 315040,China;不详)

机构地区：[1]宁波市医疗中心李惠利医院ICU,浙江315040 [2]宁波市医疗中心李惠利医院检验科

出　　处：《中国卫生检验杂志》2023年第20期2473-2476,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技项目(2021KY1031,2023KY245)。

摘　　要：目的了解宁波地区医院临床分离CRKP中mcr基因分布,以及黏菌素耐药情况,为临床治疗和医院感染控制提供依据。方法采用聚合酶链反应(PCR)扩增和琼脂糖凝胶电泳的方法,对2019年7月—2022年6月宁波地区多中心医院临床分离CRKP分别进行mcr-1、mcr-2、mcr-3、mcr-4和mcr-5基因筛查;检测CRKP对临床常见抗菌药物的耐药率;采用微量肉汤稀释法进行黏菌素(硫酸多黏菌素B和硫酸多黏菌素E)的敏感性检测。结果150株CRKP中mcr-1阳性菌株共有1株,阳性率为0.68%,未检出mcr-2、mcr-3、mcr-4和mcr-5基因;CRKP对临床常见抗菌药物的耐药性较高,极少数具有敏感性;150株CRKP对硫酸多黏菌素B和硫酸多黏菌素E的敏感率分别为97.3%和96.7%,无明显差异,其中MIC_(50)分别为1μg/ml和0.5μg/ml,MIC_(90)均为1μg/ml;mcr-1阳性菌株对硫酸多黏菌素B和硫酸多黏菌素E均耐药。结论宁波地区CRKP对临床常规抗菌药物敏感性较低,对2种黏菌素敏感性均较高,其中mcr基因分布率较低,但携带mcr-1基因菌株表现为黏菌素耐药。Objective This paper aims to understand the distribution of mcr genes in clinical carbapenem-resistant Klebsiella pneumoniae(CRKP)and the resistance to colistin in Ningbo hospitals,so as to provide basis for clinical treatment and nosocomial infection control.Methods By using polymerase chain reaction(PCR)amplification and agarose gel electrophoresis,clinical isolated CRKP from 2018 to 2021 were conducted for the screening of mcr-1,mcr-2,mcr-3,mcr-4 and mcr-5,the resistance rate of CRKP to common clinical antibiotics was detected,and the sensitivities of colistin(polymyxin sulfate B and polymyxin sulfate E)were detected by broth microdilution method.Results One mcr-1 positive strain was observed in 150 strains of CRKP,with the positive rate of 0.68%.No mcr-2,mcr-3,mcr-4,and mcr-5 genes was detected;CRKP showed higher resistance to clinically common antimicrobial agents,and very few were sensitive.The sensitivities of 150 CRKP strains to polymyxin sulfate B and polymyxin sulfate E were 97.3%and 96.7%,respectively,with MIC_(50) of 1μg/ml and 0.5μg/ml,respectively,and MIC_(90)was 1μg/ml for both of them.mcr-1 positive strains were resistant to both polymyxin sulfate B and polymyxin sulfate E.Conclusion CRKP in Ningbo has low sensitivity to conventional clinical antimicrobial drugs,including the low distribution rate of mcr gene and high sensitivity to colistin,but the strain carrying mcr-1 gene is resistant to colistin.

关 键 词：CRKP mcr基因 硫酸多黏菌素B 硫酸多黏菌素E 耐药性 

分 类 号：R446[医药卫生—诊断学]