产超广谱β-内酰胺酶肺炎克雷伯菌耐药基因分析

Drug-resistant Genes of ESBLs-producing Klebsiella pneumoniae Strains

目的了解邢台地区产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的分子流行病学特点,为临床感染预防和治疗提供依据。方法采用最小抑菌浓度(MIC)法检测产ESBLs肺炎克雷伯菌的耐药性,选取13种特异性引物采用聚合酶链反应(PCR)的方法检测产ESBLs肺炎克雷伯菌的基因类型。结果 2013年1月至2014年3月从邢台人民医院分离出的125株非重复的产ESBLs肺炎克雷伯菌菌株,耐药基因以blaCTX-M的阳性率最高,为92.0%,blaSHV和blaTEM次之,为82.9%和73.2%。所有菌株均携带1种或1种以上的耐药基因。结论产ESBLs肺炎克雷伯菌多重耐药现象严重,耐药基因以bla_(CTX-M)、bla_(SHV)和bla_(TEM)为主。医院应加强对ESBLs的监测,降低ESBLs的感染率以及耐药基因的突变,提高治疗感染的效率,防止医院感染的发生。

Objective To analyze the molecular epidemiological characteristics of ESBLs-producing KlebsieUa pneumoniae in Xingtai district and to provide the basis for clinical infection prevention and treatment. Methods Susceptibility tests of Klebsiella pneumoniae were detected by MIC method. All 13 related genes of ESBLs＇ resistant were detected by PCR technique. Results A total of 125 strains of ESBLs-producing Klebsiella pneumoniae were isolated from Xingtai People＇s Hospital from January 2013 to March 2014. The results showed that blaCTX-M had the highest positive rate was 92.0%, blas.v and blaTEM were 82.9% and 73.2%. All strains carried 1 and more kinds of resistant genes. Conclusion The ESBLs-producing KlebsieUa pneumoniae existed serious multiple drug resistance phenomenon, blaCTX-M, blas.v and bla-M were the main resistant genotypes. The hospital should strengthen monitoring for the ESBLs strains, reduce ESBLs＇ infection rates and the resistance gene mutation and improve the efficiency of the treatment and prevent hospital- aquired infection.