摘要
目的：研究肺炎克雷伯菌的耐药率与分子流行病学规律，明确其遗传背景，为临床抗菌药物的合理选择提供依据。方法收集临床分离肺炎克雷伯菌138株，采用K-B纸片扩散法进行10种常用抗菌药物的体外药物敏感性试验，对所有菌株进行多位点序列分型（MLST）。结果 MLST方案中选取的7个管家基因GC含量均分布于55.02％～65.06％。各等位基因数分布于3～6范围内，其中infB的等位基因数只有3个，而tonB的等位基因数有6个。tonB的多态性位点最多，为79个；体外药物敏感性试验结果表明，138株肺炎克雷伯菌对10种抗菌药物耐药率分布于9.42％～50.00％；MLST结果显示，全部菌株共形成9个ST型，其中ST11有78株、ST258有16株、ST340有10株、ST379有8株，上述4个ST型均属于克隆复合体CC258。此外，本次研究还发现1个新ST型。结论肺炎克雷伯菌对临床常用抗菌药物的耐药率较高，呈现多重耐药趋势；肺炎克雷伯菌的传播趋势相对集中，在院内抗生素选择压的作用下易形成典型的克隆复合体。
Objective To research the resistant rate and molecular epidemiology of Klebsiella pneumonia and clarify the genetic backgrounds, thus to provide basis for clinical use of antibiotics. Methods A total of 138 strains isolated Kleb-siella pneumoniae were collected to detect antibiotics susceptibility testing by K-B disk diffusion and multilocus sequence typing （MLST）. The eBURST and START2 software were used to analyze MLST data. Results The GC content of seven housekeeping genes included in MLST scheme were from 55.02%to 65.06%. The number of alleles was range from three to six. The infB only had three alleles while six in tonB. tonB possessed the most polymorphism sites which had seventy-nine. The antibiotics susceptibility testing showed that the resistant rate of 138 strains isolated Klebsiella pneumoniae to ten an-tibiotics were from 9.42%to 50.00%. MLST research indicated that all isolates clustered into 9 ST types, of which were 78 strains in ST11, 16 strains in ST258, 10 strains in ST340, 8 strains in ST379. They were all clustered into one clonal complex CC258. Moreover, there was one novel ST observed in this study. Conclusion The resistant rates of Klebsiella pneumoniae to clinical antimicrobial are relatively high, and emerging multiple-drug resistance tendency. Besides, the dis-semination pattern of Klebsiella pneumoniae is relatively concentrated and could form a typical clone complex easily under the nosocomial antibiotic selection pressure.
出处
《全科医学临床与教育》
2015年第5期529-532,共4页
Clinical Education of General Practice
