摘要
目的:研究本院耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药性以及菌株间的同源性。方法:全自动微生物分析仪进行细菌鉴定及药敏试验,采用改良Hodge试验和EDTA协同试验检测耐药表型,PCR检测碳青霉烯酶基因,脉冲场凝胶电泳(PFGE)分析菌株同源性。结果:26株肺炎克雷伯菌对头孢菌素类、单环β-内酰胺类、氨基糖苷类、喹喏酮类、呋喃妥因等多种抗菌药物耐药;经PCR检测后25株携带KPC基因,1株携带IMP基因,未检测出VIM、NDM-1、OXA-48基因;PFGE电泳结果显示,26株肺炎克雷伯菌分为4型。其中Ⅰ、Ⅱ为主要流行克隆型。结论:本院存在肺炎克雷伯菌耐药株的传播,携带的耐药基因以KPC-2为主,主要以ICU与MICU的2株耐药株流行,而且耐药菌株间存在着不同程度的亲缘关系。
Objective To analyze the Resistance and homology of carbapenem-resistant Klebsiella pneumonia （CRKP） in our hospital. Methods The bacterial identification and antimicrobial susceptibility testing were carried out by the automated microbial and metallo-a lactamase in Klebsiella pneumoniae were detected by modified Hodge test and EDTA-disk synergy test respectively, PCR detection ofcarbapenemase carbapenem gene, homology analysis of strain by pulsed-field gel electrophoresis （PFGE）. Results 26 carbapenem-resistant Klebsiella pneumoniae to multiple antimicrobial agents cephalosporins, monocyclic β- lactams, aminoglycosides, quinolones, nitrofurantoin resistance, etc; 25 carrying KPC gene, one carrying IMP gene,VIM, NDM-1,OXA- 23 gene was not detected; PFGE electrophoresis results showed that 26 Klebsiella pneumoniae is divided into four kinds of genotypes. Wherein I、Ⅱ as the predominant strain. Conclusion In the hospital, drug resistance isolates of K. pneumoniae have a large-scale spread, which take KPC-2 as the principal drug-resistance genes. They are mainly popular with two isolates in ICU and MICU, and drug-resistance strains have varying degrees of genetic relationship.
出处
《实用医学杂志》
CAS
北大核心
2016年第22期3728-3731,共4页
The Journal of Practical Medicine
