碳青霉烯类耐药肺炎克雷伯菌的基因分析

Analysis of resistance genes of carbapenem-resistant Klebsiella pneumoniae

目的 探讨碳青霉烯类耐药肺炎克雷伯菌(carbapenem-resistant Klebsiellapneumoniae,CRKP)的临床分离情况和耐药基因,为临床合理选用抗菌药物提供依据。方法 收集2017年—2022年南京医科大学第二附属医院150株临床分离的碳青霉烯类耐药肺炎克雷伯菌(CRKP),进行PCR检测相关耐药基因和毒力基因,包括KPC、NDM-1、IMP、OKP、LEN和iucA。结果 150株CRKP中,临床分布科室前三名的分别是呼吸内科(22.67%)、ICU重症监护室(20.00%)、肾脏内科(14.00%)。PCR的结果显示,KPC基因表达菌株131株,NDM-1基因表达菌株8株,IMP基因表达菌株1株,OKP基因表达菌株15株,LEN基因表达菌株5株,iucA基因表达菌株95株。结论 本院分离的CRKP主要携带的耐药基因是KPC,大多数携带毒力基因iucA,且在临床各个科室均有分布。

Objective This paper aims to discuss the clinical isolation and drug resistance genes of carbapenem-resistant Klebsiella pneumoniae, so as to provide basis for the rational selection of antibacterial drugs in clinical practice. Methods A total of 150 carbapenem-resistant Klebsiella pneumoniae isolates were collected from 2017 to 2022 in the Second Affiliated Hospital of Nanjing Medical University. PCR was performed to detect related resistance genes and virulence genes, including KPC, NDM-1, IMP, OKP, LEN, and iucA. Results Among the 150 CRKP strains, the top three clinical distribution departments were respiratory(22.67%), ICU intensive care unit(20.00%), and nephrology(14.00%). The PCR results showed that there were 131 strains with KPC gene expression, with 8 strains carrying NDM-1 gene, 1 strain carrying IMP gene, 15 strains carrying OKP gene, 5 strain carrying LEN, and 95 strains carrying iucA gene. Conclusion The CRKP drug-resistant genes isolated in our hospital were mainly carried by KPC, and most carried the virulence gene iucA, which is distributed in various clinical departments.