广州地区急性腹泻患儿粪便中多重耐药及高毒力肺炎克雷伯菌分布检测

发布时间：2018-04-16 07:29

本文选题：腹泻 + 儿童　；参考：《中华疾病控制杂志》2017年06期

【摘要】：目的了解广州地区急性腹泻患儿粪便中肺炎克雷伯菌的携带情况,以及其中具有多重耐药性和高毒力的肺炎克雷伯菌菌株的分布情况。方法 2015年5~9月,采集广州市某医院门诊腹泻患儿的粪便样本,分离鉴定肺炎克雷伯菌并进行药敏试验,同时筛检产超广谱β-内酰胺酶(extended-spectrumβ-lactamases,ESBLs)菌株。采用聚合酶链式反应(polymerase chain reaction,PCR)实验检测产ESBLs菌株中具有耐药基因blaTEM、blaSHV和blaCTX-M的菌株分布情况;用PCR实验检测所有分离菌株中六种常见高毒力荚膜血清型的分布情况。结果在87份腹泻患儿粪便样本中,肺炎克雷伯菌检出率为66.7%。分离株对青霉素类抗菌药物、第一代头孢菌素和呋喃妥因的耐药率较高;而对二、三、四代头孢类抗菌素、喹诺酮类、氨基糖苷类抗生素耐药性较低,且未检出耐碳青霉烯肺炎克雷伯菌;产ESBLs肺炎克雷伯菌检出率为12.1%(7/58),其中检出4株blaCTX-M和2株blaTEM基因型菌株,未检出含blaSHV基因型菌株;所有分离株的多重耐药率为27.6%。共检出高毒力肺炎克雷伯菌K2、K20、K54型各1株,未检出K1、K5及K57型。结论腹泻患儿粪便中肺炎克雷伯菌分离率较高,多重耐药性菌株比例较高,而且存在具有多重耐药同时高毒力的菌株,应引起重视。
[Abstract]:Objective to investigate the infection of Klebsiella pneumoniae in feces of children with acute diarrhea in Guangzhou and the distribution of Klebsiella pneumoniae strains with multidrug resistance and high virulence.Methods from May to September 2015, fecal samples of children with diarrhea in outpatient department of a hospital in Guangzhou were collected, Klebsiella pneumoniae was isolated and identified and drug sensitivity test was carried out. Extended-spectrum 尾 -lactamases ESBLsproducing strain was screened at the same time.Polymerase chain reaction assay (PCR) was used to detect the distribution of drug-resistant genes (chain) and blaCTX-M in ESBLs producing strains, and PCR assay was used to detect the distribution of six common highly virulent capsule serotypes in all isolates.Results the detection rate of Klebsiella pneumoniae was 66.7 in 87 fecal samples of children with diarrhea.The resistant rates of the first generation cephalosporins and furantoin to penicillin antibiotics were higher than those of the second, third and fourth generation cephalosporins, quinolones and aminoglycoside antibiotics.The detection rate of Klebsiella pneumoniae producing ESBLs was 12. 1%, 4 strains of blaCTX-M and 2 strains of blaTEM genotype were detected, and the rate of multidrug resistance of all isolates was 27. 6%.One strain of highly virulent Klebsiella pneumoniae K _ 2 K _ 20 K _ (54) was detected, and no K _ (1) K _ (5) and K _ (57) were detected.Conclusion the isolation rate of Klebsiella pneumoniae in feces of children with diarrhea is high, the proportion of multidrug resistant strains is high, and the strains with multidrug resistance and high virulence should be paid more attention to.
【作者单位】：南方医科大学公共卫生学院流行病学系;广州市越秀区疾病预防控制中心病媒生物疾病防制科;南方医科大学第三附属医院检验科;
【基金】：国家自然科学基金(81573210)
【分类号】：R725.7

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