69株碳青霉烯类耐药肺炎克雷伯菌耐药基因检测分析

Detection and analysis of drug resistance genes in 69 carbapenem resistance Klebsiella pneumoniae strains

目的了解耐碳青霉烯类抗生素的肺炎克雷伯菌耐药基因的携带情况。方法收集69株浙江省人民医院住院病人耐碳青霉烯的肺炎克雷伯菌株,改良Hodge试验进行KPC型碳青霉烯酶初筛检测,PCR法进行HSV、OXA-1群、OXA-2群、OXA-10群、GES、VEB、IMP、VIM、SME、KPC、IMI/NMC、NDM基因检测,并对部分阳性基因进行测序。结果 69株肺炎克雷伯菌改良Hodge试验阳性48株,阳性率63.8%。PCR检测结果为56株(81.2%)携带KPC基因,60株(87%)携带HSV,20株(29.0%)携带OXA-3基因;3株(4.35%)肺炎克雷伯菌携带OXA-1基因。对KPC基因测序结果为KPC-2亚型。结论本次检测的耐碳青霉烯类肺炎克雷伯菌携带KPC-2基因为主,应加强院感监测和预防。

Objective To understand the drug resistance genes carried on carbapenem resistance Klebsiella pneumoniae strains. Methods 69 carbapenem resistance K. pneumoniae strains were collected from inpatients in Zhejiang Provincial People＇ s Hospital, modified Hodge test was used to screen KPC-carbapenemase, HSV, OXA-lgroup, OXA-2 group, OXA-10 goup, GES, VEB, IMP, VIM, SME, KPC, IMI/NMC and NDM gene were detected with PCR and some amplified products were analyzed by sequencing. Results Of 69 carbapenem resistance K. pneumoniae strains, 48 strains （63.8%） were positive for modified Hodge test, KPC gene were detected in 56 strains （81.2%）, HSV, OXA-3 and OXA-1 were detected in, 60 （87%）, 20 （29.0%）and 3 （4.35%）strains respectively. Sequence analysis revealed that the detected KPC genes were KPC-2. Conclusion KPC-2 gene was the mainly carried gene in carbapenem resistance K. pneumoniae strains, and more attention should be paid to hospital infection monitor and prevent the dissemination of these strains.