108株耐碳青霉烯肺炎克雷伯菌的临床分布与耐药基因研究

发布时间：2018-06-08 19:35

本文选题：CRKP + 临床分布　；参考：《中国抗生素杂志》2017年03期

【摘要】：目的了解仁济医院耐碳青霉烯肺炎克雷伯菌株(carbapenem-resistant Klebsiella pneumoniae,CRKP)的临床分布与耐药基因型。方法收集2013年1月—2015年7月仁济医院临床分离108株CRKP,进行K-B纸片法检测18种抗菌药物敏感性、超广谱β-内酰胺酶(ESBLs)初筛及表型确证试验、聚合酶链反应检测ESBLs、碳青霉烯酶、质粒介导的AmpC酶与喹诺酮耐药基因。结果 108株CRKP对复方磺胺耐药率最低(32.4%),其次为磷霉素、庆大霉素和阿米卡星(82.4%、95.4%和97.2%)。科室分布前3位为神经外科、外科ICU和普外科。ESBLs基因中CTX-M-9,SHV和TEM酶基因阳性率为96.3%、85.2%和75.9%。108株CRKP均检测出KPC-2基因。而金属酶基因仅1株检测出IMP-1。喹诺酮耐药基因中qnrB基因检出率达91.7%(99/108)。AmpC酶中只检测出DHA基因,阳性率13.9%(15/108)。结论我院临床分离CRKP携带多种耐药基因,对数10种临床常用抗菌药物同时耐药,应加强对该类菌株的监控,控制其在院内的传播流行。
[Abstract]:Objective to investigate the clinical distribution and genotypes of carbapenem-resistant bsiella Kleoniae CRKP in Renji Hospital. Methods 108 clinical isolates of CRKPwere collected from January 2013 to July 2015 in Renji Hospital. The susceptibility of 18 antimicrobial agents was detected by K-B disk method. Extended-spectrum 尾 -lactamase (ESBLs) screening and phenotypic confirmatory tests were performed, and ESBLsand carbapenem were detected by polymerase chain reaction (PCR). Plasmid mediated AMPC enzyme and quinolone resistance gene. Results 108 strains of CRKP had the lowest resistance to compound sulfanilamide, followed by fosfomycin, gentamicin and amikacin 82.4% and 97.2%. The positive rates of CTX-M-9 SHV and TEM genes in ICU and general surgery department were 96.3% and 75.9% respectively. KPC-2 gene was detected in 75.108 strains of CRKP. Only one strain of metallozyme gene detected IMP-1. The detection rate of qnrB gene in quinolone resistance gene was 91.7% and only DHA gene was detected in 99- / 108- .AMPC enzyme. Conclusion the clinical isolates of CRKP carry a variety of drug resistance genes, and 10 commonly used antimicrobial drugs are resistant at the same time. The surveillance of these strains should be strengthened to control the spread of CRKP in hospital.
【作者单位】：上海交通大学医学院附属仁济医院检验科;
【基金】：上海市卫生局青年科研项目(No.20134Y209)
【分类号】：R440

【相似文献】