耐碳青霉烯类肺炎克雷伯菌耐药基因检测及同源性
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黄峰

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R181.3+2 R378.99

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蚌埠医学院科研课题项目(BYKY16170)


Detection of drug resistance genes and homology of carbapenemresistant Klebsiella pneumoniae
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    摘要:

    目的探讨耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药基因型及同源性。方法收集某院2015年9月—2016年2月临床标本分离的38株CRKP,采用聚合酶链反应(PCR)方法检测耐药基因型,脉冲场凝胶电泳(PFGE)分析菌株同源性。结果38株CRKP主要来源于重症监护病房(ICU)及外科重症监护病房(SICU),分别占39.48%、34.21%。38株CRKP均检出blaKPC和blaSHV耐药基因,6株检出blaCTX耐药基因。PFGE显示共分成A、B、C、D 4个谱型,其中以C型为主(65.78%,25/38)。A型菌株中菌株14、15、16携带blaKPC2型、blaSHV型、blaCTXM15耐药基因,此3株细菌均是SICU患者分离的,菌株14和15分离自同一天,菌株16分离时间延后一周;C型菌株中,菌株10、18、25、28的同源性为100%,菌株10、18分离自ICU患者,菌株25、28分离自神经内一科患者(均从ICU转出),均是在ICU住院期间检出,且分离时间相差1 d。结论该院CRKP耐药基因型以blaKPC及blaSHV为主,存在克隆株医院内流行。

    Abstract:

    ObjectiveTo explore the drugresistant genotypes and homology of carbapenemresistant Klebsiella pneumoniae (CRKP). Methods38 strains of clinically isolated CRKB in a hospital between September 2015 and February 2016 were collected, drug resistance genes were detected with polymerase chain reaction (PCR), homology of strains was analyzed with pulsedfield gel electrophoresis (PFGE). ResultsAll 38 strains were from intensive care unit(ICU) and surgical intensive care unit(SICU), accounting for 39.48% and 34.21% respectively. 38 strains all harboured drug resistance genes blaKPC and blaSHV , 6 strains harboured blaCTX. PFGE revealed that strains were divided into types A, B, C, and D, type C was predominant(65.78%,25/38). Of type A strains, strains 14, 15, and 16 carried drug resistance genes blaKPC2, blaSHV, and blaCTXM15 respectively, these strains were all isolated from SICU patients, strains 14 and 15 were isolated on the same day, strain 16 was isolated on the following week; of type C strains, homology of strain 10, 18, 25, and 28 was 100%. strian 10 and 18 were isolated from ICU patients, strains 25 and 28 were isolated from patients in division I of neurology ICU( both were transferred from ICU), and both were isolated during patient hospitalization in ICU, the isolation time only differed for one day.ConclusionThe main drugresistant genotypes of CRKB in this hospital are mainly blaKPC and blaSHV,  there is epidemic of clone strains in this hospital.

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黄峰,许元元.耐碳青霉烯类肺炎克雷伯菌耐药基因检测及同源性[J]. 中国感染控制杂志,2018,17(1):21-25. DOI:10.3969/j. issn.1671-9638.2018.01.005.
HUANG Feng, XU Yuanyuan. Detection of drug resistance genes and homology of carbapenemresistant Klebsiella pneumoniae[J]. Chin J Infect Control, 2018,17(1):21-25. DOI:10.3969/j. issn.1671-9638.2018.01.005.

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  • 收稿日期:2017-03-26
  • 最后修改日期:2017-06-23
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  • 在线发布日期: 2017-12-29
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