耐碳青霉烯类肺炎克雷伯菌的分子流行病学特征分析  

Analysis of molecular epidemiological characteristics of carbapenem resistant Klebsiella pneumoniae

作　　者：沈垲智 刘卫平 王涛 SHEN Kai-zhi;LIU Wei-ping;WANG Tao(Inner Mongolia Medical University,Hohhot Inner Mongolia 010110,China;Inner Mongolia Autonomous Region People’s Hospital)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010110 [2]内蒙古自治区人民医院

出　　处：《中国消毒学杂志》2024年第7期518-520,523,共4页Chinese Journal of Disinfection

基　　金：传染病预防控制国家重点实验室自主研究项目(2019SKID205);中国老年医学学会感染防控研究基金资助项目(GRYJ-LRK2018021);内蒙古自治区自然科学基金项目[2017MS(LH)0845];内蒙古自治区人民医院院内基金项目(2021YN03)。

摘　　要：目的分析耐碳青霉烯类肺炎克雷伯菌(CRKP)的分子流行病学特征。方法选取内蒙古自治区人民医院2022年3月—2023年3月临床分离的CRKP菌株,进行药物敏感性试验、脉冲场凝胶电泳(PFGE)及全基因组测序(WGS)。结果共分离到33株CRKP菌株,其中81.81%来自痰液标本。CRKP对大多数常用抗菌药物耐药率较高,对替加环素最敏感,耐药率为3.03%。PFGE结果显示,33株CRKP分为26个簇,其中8株菌在同一簇。对这8株菌进行WGS,所得序列通过全基因组SNP分析得知,最大差异碱基为22个,具有同源性。结论CRKP在某医院长期存在并隐性传播,应规范使用抗菌药物,落实院内感染预防控制措施并定期监测,预防医院感染的暴发。Objective To analyze the molecular epidemiological characteristics of carbapenem resistant Klebsiella pneumoniae(CRKP).Methods CRKP strains isolated from the Inner Mongolia Autonomous Region People’s Hospital from March 2022 to March 2023 were selected to conduct drug sensitivity test,pulsed field gel electrophoresis(PFGE)and whole genome sequencing(WGS).Results A total of 33 strains of CRKP were isolated,of which 81.81%were from sputum samples.CRKP had high resistance to most commonly used antibiotics,and was most sensitive to tigecycline,with a resistance rate of 3.03%.PFGE results showed that 33 strains of CRKP were divided into 26 clusters,of which 8 strains were in the same cluster.After WGS for the 8 strains,the obtained sequences were analyzed by whole genome SNP,and they were homology due to the maximum difference of 22 bases.Conclusion CRKP has been present in a hospital for a long time and has silent transmission.It is necessary to standardize the use of antibiotics,strengthen hospital infection prevention and control measures,and regularly monitor to prevent the outbreak of hospital infections.

关 键 词：耐碳青霉烯类肺炎克雷伯菌 药敏试验 脉冲场凝胶电泳 全基因组测序 

分 类 号：R378[医药卫生—病原生物学]