某医院2012-2013年242株肺炎克雷伯菌β-内酰胺酶及整合子耐药基因检测  

Detection of Beta lactamase and integron genes in 242 strains of Klebsiella pneumoniaisolated in a hospital from 2012 to 2013

作　　者：郭普[1] 贺晓珊 梅传忠[2] 李兴武[1] 刘双成[1] 沈继龙[3] 

机构地区：[1]蚌埠医学院第一附属医院检验科,蚌埠233004 [2]蚌埠医学院医学检验系,蚌埠233003 [3]安徽病原生物学省级实验室和人兽共患病安徽省重点实验室安徽医科大学病原学教研室,合肥230032

出　　处：《中国人兽共患病学报》2015年第5期437-440,452,共5页Chinese Journal of Zoonoses

基　　金：蚌埠医学院研究生科研创新计划项目(No.byycxz1306)资助~~

摘　　要：目的了解肺炎克雷伯菌主要的β-内酰胺酶和整合子耐药基因型,明确其耐药特性。方法回顾性分析我院2012年1月至2013年5月临床分离的242株肺炎克雷伯菌药敏结果,聚合酶链反应(PCR)检测其β-内酰胺酶及整合子耐药基因。结果 242株肺炎克雷伯菌对16种抗生素存在不同程度的耐药,其中氨曲南、头孢唑啉、氨苄西林/舒巴坦、头孢曲松和头孢他啶耐药率较高,分别为76.86%、65.70%、63.64%、62.40%和59.92%;亚胺培南、丁胺卡那、厄他培南和哌拉西林/他唑巴坦较为敏感,分别为17.77%、18.88%、18.88%和23.55%。PCR结果显示,ESBLs基因阳性155株,占64.05%,主要为TEM型和SHV型,两者均存在的菌株有114株,占产ESBLs基因菌株的73.55%(114/155)。其次为KPC基因86株,占35.54%;此外AmpC基因43株,占17.77%,全部为DHA型。整合子基因128株,占52.89%,以整合子1(intI-1)为主,共检出120株,占49.59%。结论我院肺炎克雷伯菌耐药情况严重,主要的耐药基因型为TEM型、SHV型、KPC和intI-1。To analyze the genotype and molecular epidemiology of beta lactamase and integron in Klebsiella pneumonia,242 strains were isolated from the clinic from Jan 2012 to May 2013 in our hospital and their drug susceptibility were retrospectively analyzed.Furthermore,drug-resistant genes for Beta lactamase and integron were detected using polymerase chain reaction(PCR).Results showed that among 242 Klebsiella pneumonia strains,the drug-resistant rates to aztreonam,cefazolin,ampicillin/sulbactam,cefatriaxone and ceftazidime were 76.86%,65.70%,63.64%,62.40%,and 59.92%,respectively,whereas the rates to imipenem,amikacin,ertapenem and piperacillin/tazobactam were only 17.77%,18.88%,18.88%,and23.55%,respectively.And ESBLs gene was confirmed in 155 strains using PCR,accounting for 64.05%.Among which,114 strains were confirmed to carry with TEM and SHV genotypes,accounting for 73.55%(114/155).Eighty-six strains with KPC gene,accounting for 35.54%,and 43 strains with AmpC gene,accounting for 17.77%and all were DHA type.Integron gene was detected in 128 strains,accounting for 52.89%(128/242);120of which were confirmed to carry with integron-1(intI-1),accounting for 49.59%(120/242).There was a high prevalence of drug-resistance of Klebsiella pneumoniain our hospital,and the main drug-resistance genotypes were TEM,SHV,KPC and intI-1.

关 键 词：肺炎克雷伯菌 耐药 基因 聚合酶链反应(PCR) 

分 类 号：R440[医药卫生—诊断学]