耐碳青霉烯类肺炎克雷伯菌分子流行病学研究
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梁建生

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R181.3+2

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2017年度武汉市临床医学科研项目(公共卫生及卫生政策类)(WG17Q02)


Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae
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    摘要:

    目的 分析武汉两所医院耐碳青霉烯类肺炎克雷伯菌(CRKP)临床分离株产碳青霉烯酶的情况,以及分子流行病学特征。方法 收集武汉两所医院2018年1-10月临床分离的42株非重复CRKP,采用Carba NP试验方法对菌株产碳青霉烯酶情况进行初筛,聚合酶链反应(PCR)检测碳青霉烯酶基因携带情况,采用质粒接合试验分析耐药基因的水平转移情况,应用脉冲场凝胶电泳(PFGE)进行亲缘关系分析。结果 42株CRKP菌株中14株Carba NP试验阳性,其中有10株扩增出NDM-1基因,3株扩增出KPC-2基因。共13株CRKP碳青霉烯基因检测阳性,其中12株质粒接合试验成功。PFGE分析结果显示,携带NDM-1基因的CRKP菌株共分成6型,无明显优势型;携带KPC-2基因的CRKP菌株为同一型别。结论 检出产NDM-1和KPC-2的CRKP菌株,质粒接合试验提示质粒介导的水平传播在碳青霉烯酶基因的播散过程中可能起重要作用。

    Abstract:

    Objective To analyze carbapenemase production and molecular epidemiological characteristics of clinically isolated carbapenem-resistant Klebsiella pneumoniae (CRKP) from two hospitals in Wuhan City. Methods 42 non-repetitive CRKP strains were collected from two hospitals in Wuhan City from January to October 2018, carbapenemase production was screened by Carba NP test, carriage of carbapenemase genes was detected by polyme-rase chain reaction (PCR), horizontal transfer of drug resistance genes was analyzed by plasmid conjugation test, phylogenetic relationship was analyzed by pulsed-field gel electrophoresis (PFGE). Results Of 42 CRKP strains, 14 were positive for Carba NP test, 10 of which were amplified NDM-1 gene and 3 amplified KPC-2 gene. A total of 13 CRKP strains were positive for carbapenem gene detection, 12 of which were successful in plasmid conjugation test. PFGE showed that CRKP strains carrying NDM-1 gene were classified into 6 types, there was no dominant type; CRKP strains carrying KPC-2 gene were of the same type. Conclusion NDM-1 and KPC-2-producing CRKP strains were detected, plasmid conjugation test suggested that plasmid-mediated horizontal transfer might play an important role in the dissemination of carbapenemase genes.

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龚林, 刘小丽, 许慧琼,等.耐碳青霉烯类肺炎克雷伯菌分子流行病学研究[J]. 中国感染控制杂志,2019,18(7):643-647. DOI:10.12138/j. issn.1671-9638.20194528.
GONG Lin, LIU Xiao-li, XU Hui-qiong, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae[J]. Chin J Infect Control, 2019,18(7):643-647. DOI:10.12138/j. issn.1671-9638.20194528.

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  • 收稿日期:2018-12-29
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  • 在线发布日期: 2019-07-28
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