中国2017—2018年耐碳青霉烯类肺炎克雷伯菌药物敏感性及耐药基因分析
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北京大学第一医院临床药理研究所, 北京 100034

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李耘 E-mail: liyun19702@ sina.com

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Antimicrobial susceptibility and resistance genes of carbapenem-resistant Klebsiella pneumoniae in China from 2017 to 2018
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Institute of Clinical Pharmacology, Peking University First Hospital, Beijing 100034, China

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    摘要:

    目的 分析中国耐碳青霉烯类肺炎克雷伯菌(CRKP)药物敏感性及耐药基因携带情况。 方法 对北京大学临床药理研究所2017—2018年中国细菌耐药监测研究中收集的CRKP进行药敏试验,采用聚合酶链反应(PCR)及测序检测CRKP中碳青霉烯酶基因和其他广谱、超广谱β-内酰胺酶(ESBLs)基因携带情况。 结果 共筛选出129株CRKP,抗菌效果较好的药物包括多粘菌素E、替加环素、磷霉素氨丁三醇、米诺环素,敏感率分别为80.62%、79.07%、51.16%、51.16%,其余药物敏感率均低于46%。PCR及测序结果显示,112株携带碳青霉烯酶基因,主要为blaKPC-2基因(77.52%)和blaNDM基因(8.53%),3株(2.33%)同时携带blaKPCblaNDM基因。blaTEM基因检出率为51.94%(67/129),均为blaTEM-1blaSHV基因检出率为64.34%(83/129),主要为blaSHV-12基因(27.91%,36/129);blaCTX-M基因检出率为53.49%(69/129),分别为blaCTX-M-9(43.41%)和blaCTX-M-15(10.08%),其中4株(3.10%)同时含blaCTX-M-9blaCTX-M-15基因。碳青霉烯酶基因阳性菌株中,80.36%(90/112)同时携带ESBLs基因,32.14%(36/112)同时携带2种或以上ESBLs基因。 结论 中国临床分离的CRKP耐药情况严重,而且同时含多种耐药基因,其中最常见的碳青霉烯酶基因是blaKPC-2基因,最常见的ESBLs基因是blaSHV-12基因和blaCTX-M-9基因。

    Abstract:

    Objective To analyze antimicrobial susceptibility and carrying status of antimicrobial resistance genes of carbapenem-resistant Klebsiella pneumoniae (CRKP) in China. Methods Antimicrobial susceptibility testing was performed on CRKP collected from the China Antimicrobial Resistance Surveillance Trial from 2017 to 2018 by Institute of Clinical Pharmacology of Peking University, carrying status of carbapenemase genes and other extended-spectrum beta-lactamases (ESBLs) genes in CRKP were detected by polymerase chain reaction (PCR) and sequencing detection. Results A total of 129 strains of CRKP were screened out, polymyxin E, tigecycline, fosfomycin trometamol and minocycline were the effective antimicrobial agents, susceptibility rates were 80.62%, 79.07%, 51.16% and 51.16% respectively, susceptibility rates of other antimicrobial agents were all lower than 46%. PCR and sequencing results showed that 112 strains carried carbapenemase gene, mainly blaKPC-2 (77.52%) and blaNDM (8.53%) genes, and 3 strains (2.33%) carried both blaKPC-2 and blaNDM genes. Detection rate of blaTEM gene was 51.94% (67/129), all of which were blaTEM-1; detection rate of blaSHV gene was 64.34% (83/129), mainly blaSHV-12 gene (27.91%, 36/129); detection rate of blaCTX-M gene was 53.49% (69/129), which were blaCTX-M-9 (43.41%) and blaCTX-M-15 (10.08%) respectively, 4 strains (3.10%) contained both blaCTX-M-9 and blaCTX-M-15 genes. Among carbapenemase gene positive strains, 80.36% (90/112) carried ESBLs genes simultaneously, and 32.14% (36/112) carried two or more ESBLs genes simultaneously. Conclusion Antimicrobial resistance of CRKP isolated in China is serious, and there are multiple antimicrobial resistance genes at the same time, the most common carbapenemase gene is blaKPC-2 gene, and the most common ESBLs genes are blaSHV-12 and blaCTX-M-9 genes.

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引用本文

王青,李耘,郑波.中国2017—2018年耐碳青霉烯类肺炎克雷伯菌药物敏感性及耐药基因分析[J]. 中国感染控制杂志,2021,(5):437-442. DOI:10.12138/j. issn.1671-9638.20217706.
Qing WANG, Yun LI, Bo ZHENG. Antimicrobial susceptibility and resistance genes of carbapenem-resistant Klebsiella pneumoniae in China from 2017 to 2018[J]. Chin J Infect Control, 2021,(5):437-442. DOI:10.12138/j. issn.1671-9638.20217706.

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  • 收稿日期:2020-06-30
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  • 在线发布日期: 2021-07-26
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