肠杆菌科细菌KPC型碳青霉烯酶的研究

Study on Klebsiella pneumoniae carbapenemase in isolates of Enterobacteriaceae

目的了解某院临床分离的肠杆菌科细菌产KPC型碳青霉烯酶情况及其基因型别。方法收集该院2009—2010年临床分离的肠杆菌科细菌1 801株,经药敏试验筛选出耐药性高的菌株,采用改良Hodge试验和聚合酶链反应(PCR)扩增检测细菌产KPC型碳青霉烯酶情况,并测序分析其基因型别。结果 1 801株肠杆菌科细菌中,有783株(43.48%)对第三代头孢菌素耐药,其中4株还对碳青霉烯类抗菌药物耐药;改良Hodge试验初筛出2株耐药菌株,经PCR扩增证实为碳青霉烯酶blaKPC-2基因。结论该院已出现产KPC-2型碳青霉烯酶耐药基因的肠杆菌科细菌,临床与实验室应加强监测和控制。

Objective To investigate the Klebsiella pneumoniae carbapenemase（KPC） production in clinical isolates of Enterobacteriaceae in a hospital.Methods 1 801 clinical Enterobacteriaceae isolates were collected from this hospital from 2009 to 2010.Highly drug-resistant strains were screened by antimicrobial susceptibility testing,KPC-type carbapenemase was detected with the modified Hodge testing and polymerase chain reaction（PCR）,and DNA sequencing was performed to confirm carbapenemase genotypes.Results Of 1 801 Enterobacteriaceae isolates,783（43.48%） were resistant to the third cephalosporins,4 of which were also resistant to carbapenem;2 isolates were screened as drug-resistant strains by Hodge testing,and blaKPC-2 gene was identified in this 2 isolates by PCR.Conclusion KPC-2 Enterobacteriaceae strains with carbapenemase-producing drug-resistant gene have emerged in this hospital,monitor and control should be strengthened.