产KPC肺炎克雷伯菌暴发流行的药敏特点与同源性分析

发布时间：2018-01-06 05:15

本文关键词：产KPC肺炎克雷伯菌暴发流行的药敏特点与同源性分析　出处：《中华医院感染学杂志》2016年22期 　论文类型：期刊论文

【摘要】：目的研究分析北京某三甲医院2014年10-11月产KPC型碳青霉烯酶肺炎克雷伯菌暴发流行的药敏特点及其与同源性的关系,为进行有效预防控制提供分子流行病学证据。方法收集2014年10-11月分离自临床和医院感染监测产KPC酶肺炎克雷伯菌20株,通过PCR测定KPC型碳青霉烯酶基因,微量肉汤法测定最小抑菌浓度,对于感染有KPC型肺炎克雷伯菌患者的临床资料进行回顾性调查与研究。结果分离鉴定出产KPC肺炎克雷伯菌外科ICU 11株、内科ICU 2株、其他科室7株;分为A型和B型,其中A型共17株,B型3株;A型菌株除对米诺环素、多粘菌素B敏感外对其余包括碳青霉烯类抗菌药物在内的所有抗菌药物均表现出不同程度的耐药,B型菌株对米诺环素、多粘菌素B、庆大霉素、阿米卡星表现出一定程度的敏感外,对其他抗菌药物也均表现为不同程度的耐药。结论本次产KPC型肺炎克雷伯菌暴发,存在克隆传播的可能,不同的克隆株对药物的敏感性有较大差异,对临床的抗菌药物应用带来极大挑战,同时临床科室应积极加强防护措施,防止再次产KPC型肺炎克雷伯菌暴发流行。
[Abstract]:Objective to study the characteristics of drug sensitivity analysis in a hospital in Beijing in 2014 10-11 month KPC carbapenemase in Klebsiella pneumoniae outbreak and its homology with the relationship, for the effective prevention and control to provide molecular epidemiological evidence. Methods from 2014 10-11 month isolated from clinical and hospital infection monitoring KPC producing Klebsiella pneumoniae determination of 20 strains, KPC type carbapenemase gene by PCR, the minimum inhibitory concentration was determined with broth microdilution method for clinical data of KPC infection of Klebsiella pneumonia patients were retrospectively investigated and studied. Results the isolation and identification of KPC producing Klebsiella pneumoniae in surgical ICU 11 strains, 2 strains of ICU in other departments, 7 strains; divided into A type and B type, A type 17 strains, 3 strains of type B; A strain in addition to minocycline and polymyxin B were sensitive to all antibiotics including the carbapenem antibiotics, A different degree of resistance, B strains of minocycline and polymyxin B, gentamicin, Amikacin showed sensitive to a certain extent, to the other antimicrobial agents showed different degrees of resistance. The conclusion of the KPC type Klebsiella pneumonia outbreak, cloning spread, the drug sensitivity the different clones have great differences, brought great challenges to the clinical application of antibacterial drugs, and clinical departments should actively strengthen protective measures to prevent re production of KPC type Klebsiella pneumonia outbreak.

【作者单位】：武警总医院检验科;徐州医学院附属医院检验科;
【基金】：中华医院感染控制研究基金资助项目(ZYGY001) 武警总医院科研基金资助项目(WZ20130109)
【分类号】：R446.5
【正文快照】： 肺炎克雷伯菌(KP)是临床上常见耐药菌之一,其耐药机制主要是产超广谱β-内酰胺酶(ESBLs)和头孢菌素水解酶(AmpC)。碳青霉烯类抗菌药物具有抗菌谱广,抗菌活性强的一类β内酰胺类抗菌药物,因其具有对β-内酰胺酶作用稳定及毒性低等特点,已成为临床治疗严重肺炎克雷伯菌感染的主

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