摘要
目的研究本院感染性肺炎克雷伯菌碳青霉烯酶基因分布与耐药相关性。方法回顾性分析本院肺炎克雷伯菌耐药现状,收集26株耐碳青霉烯类肺炎克雷伯菌,依次进行ESBLs检测、改良Hodge实验、金属β-内酰胺酶检测(EDTA协同试验),三维试验检测Amp C酶;应用PCR技术进行碳青霉烯酶相关耐药基因检测,应用多位点序列分析(MLST)与e BURST分析,对肺炎克雷伯菌耐药菌进行分型与进化关系分析。结果本院耐碳青霉烯类耐药率逐年上升,2014年达8.2%。13株(50.0%)产碳青霉烯酶,8株(30.7%)产Amp C酶,2株(7.7%)产金属β-内酰胺酶;26株实验菌中PCR扩增结果示:KPC 12株,SHV 12株,TEM 5株,CTX 2株;未检出B类、C类、D类β-内酰胺酶基因;26株实验菌分为10个ST型,以ST11、ST15和ST764为主(各5株)。结论本院肺炎克雷伯菌耐药及多重耐药性严重,以KPC-2为主,本地区多重耐药肺炎克雷伯菌具有基因多态性,主要克隆系为ST11、ST15、ST764。
Objective To investigate the gene distribution of carbapenemases in Klebsiella pneumoniae and the correlation of drug resistance. Methods 26 strains of Klebsiella pneumoniae resistant to carbapenems were collected. ESBLs test,modified Hodge experiment,metal β- lactamase detection（ EDTA coordination test）,three- dimensional test were used to detect Amp C enzyme; PCR technology was used to detect resistance gene related to carbapenemases; multiple loci（ MLST） and e BURST analysis were used to study the genotype and evolution relation of resistant bacteria to Klebsiella pneumoniae. Results The resistant rate of resistant to carbapenemases in our hospital increased year by year,rising to 8. 2% in 2014. 13 strains（ 50. 0%）produced carbapenemases,8 strains（ 30. 7%） produced Amp C enzyme,and 2 strains produced β- lactamase（ 7. 7%） were positive in EDTA test; 26 experimental fungus strains in the PCR showed： KPC 12 strains,SHV 12 strains,TEM 5 strains,CTX 2 strains; the class B,C,D class β- lactamase gene did not be checked out; 26 strains were divided into 10 ST types,most were ST11,ST15 and ST764（ each had 5 strains）. Conclusion The Klebsiella pneumoniae resistant and multiple drug resistance was serious,and most were KPC- 2. Multiple drug- resistant Klebsiella pneumoniae bacteria had a gene polymorphism in this region,and the main cloning system were ST11,ST15,ST764.
出处
《中国卫生检验杂志》
CAS
2016年第3期442-446,共5页
Chinese Journal of Health Laboratory Technology
基金
瑞安市科技局项目(MS2015036)
关键词
肺炎克雷伯菌
碳青霉烯酶
耐药性
耐药机制
Klebsiella pneumoniae
Carbapenemases
Drug resistance
Resistance mechanism
