耐亚胺培南肺炎克雷伯菌耐药基因检测与分子流行病学研究

发布时间：2018-05-06 09:27

  本文选题：肺炎克雷伯菌 + 耐药基因　； 参考：《中华医院感染学杂志》2016年12期

【摘要】：目的对耐亚胺培南肺炎克雷伯菌的耐药基因携带情况及分子流行病学特征进行研究,以降低耐药率。方法对2013年10月-2014年5月临床分离的15株耐亚胺培南肺炎克雷伯菌,采用Hodge试验检测碳青霉烯酶表型;采用PCR法检测碳青霉烯酶、AmpC酶和ESBLs耐药基因及整合子,进行测序及网上比对确定基因型;采用肠杆菌科基因间重复序列(ERIC)和多位点序列分型(MLST)对菌株进行同源性和遗传相关性研究。结果 15株耐亚胺培南肺炎克雷伯菌均检出KPC-2、TEM-1、SHV和CTX-M型基因,SHV12和CTX-M-24为主要基因亚型;未检测到IMP、VIM、OXA和NDM碳青霉烯酶基因和AmpC酶基因;各带有Ⅰ类整合子,整合的主要耐药基因为aadA2;同源性和遗传相关性分析,15株耐亚胺培南肺炎克雷伯菌可分为A、B、C 3种ERIC类别,12株A菌为ST11型,2株B菌为ST290和ST147,1株C菌为ST967;15株肺炎克雷伯菌呈多药耐药或泛耐药,仅磺胺甲VA唑/甲氧苄啶的敏感率50.0%。结论 15株肺炎克雷伯菌的多药耐药或泛耐药与菌株携带KPC-2碳青霉烯酶、CTX-M型ESBLs和其他β-内酰胺酶及整合子有关;产KPC-2肺炎克雷伯菌在神经外科病区呈克隆传播,ST11型菌株为此次流行的主要株;发现ST290和ST967型产KPC-2肺炎克雷伯菌。
[Abstract]:Objective to study the gene carrying and molecular epidemiology of imipenem-resistant Klebsiella pneumoniae in order to reduce the drug resistance rate. Methods Fifteen strains of Klebsiella pneumoniae resistant to imipenem were isolated from October 2013 to May 2014. The phenotype of carbapenem was detected by Hodge test, and the genes and integrons of carbapenem enzyme AMPC and ESBLs resistant genes were detected by PCR assay. The genotypes were determined by sequencing and net alignment, and the homology and genetic correlation of the strains were studied by means of ERICI and MLSTs. Results all 15 strains of Klebsiella pneumoniae resistant to imipenem pneumoniae were found to be the main subtypes of KPC-2TEM-1SHV and CTX-M type genes, and no Imphodopsin OXA and NDM carbapenase genes and AmpC genes were detected, each with class 鈪，

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