摘要
目的了解耐碳青霉烯肠杆菌科细菌(CRE)的耐药机制及分子流行病学特征。方法采用全自动微生物鉴定系统鉴定菌株,并进行药物敏感性试验;采用改良碳青霉烯类灭活试验(mCIM)筛查菌株碳青霉烯酶;采用聚合酶链反应(PCR)及基因测序方法检测菌株碳青霉烯酶耐药基因;采用多位点序列分型(MLST)方法对菌株进行分子分型。结果共收集到24株CRE,其中13株为肺炎克雷伯菌,11株为阴沟肠杆菌,mCIM阳性率均为100%。13株肺炎克雷伯菌中有10株携带blaKPC-2基因,1株携带blaNDM-1基因,1株携带blaNDM-4基因,1株未检出blaKPC、blaIMP、blaVIM、blaNDM及blaOXA基因;11株阴沟肠杆菌均携带blaNDM-1基因。MLST结果显示13株肺炎克雷伯菌中有12株为ST11型,1株为ST571型;11株阴沟肠杆菌均为ST93型。结论研究涉及的肺炎克雷伯菌碳青霉烯类耐药的主要机制为携带blaKPC-2基因,优势序列分型(ST)为ST11;阴沟肠杆菌碳青霉烯类耐药的主要机制为携带blaNDM-1基因,优势ST为ST93。应及时采取有效措施防止CRE的传播。
Objective To study the carbapenem resistance mechanism and molecular epidemiology of carbapenem-resistant Enterobacteriaceae(CRE).Methods The identification of bacteria was performed by automatic microbial identification and analysis system.The drug susceptibility test was performed.The modified carbapenem inactivation method(mCIM)was used to screen carbapenemase,and the drug resistance genes of carbapenemase were detected by polymerase chain reaction(PCR)and gene sequencing.The molecular typing was carried out by multilocus sequence typing(MLST)analysis.Results A total of 13 carbapenem-resistant Klebsiella pneumoniae and 11 carbapenem-resistant Enterobacter cloacae were collected.The positive rate of mCIM was 100%.In the 13 carbapenem-resistant Klebsiella pneumoniae,10 isolates carried blaKPC-2,1 isolate carried blaNDM-1,and 1 isolate carried blaNDM-4,1 isolate was not detected blaKPC,blaIMP,blaVIM,blaNDM and blaOXA.The 11 carbapenemresistant Enterobacter cloacae carried blaNDM-1.MLST results showed that in the 13 carbapenem-resistant Klebsiella pneumoniae,12 isolates were ST11,and 1 isolate was ST571,while the 11 carbapenem-resistant Enterobacter cloacae were ST93.Conclusions The main mechanism of carbapenem-resistant Klebsiella pneumoniae is carrying blaKPC-2,and the dominant sequence type(ST)is ST11.The main mechanism of carbapenem-resistant Enterobacter cloacae is carrying blaNDM-1,and the dominant is ST93.
作者
温伟洪
梁英健
马芙蓉
李玉珍
徐令清
WEN Weihong;LIANG Yingjian;MA Furong;LI Yuzhen;XU Lingqing(Department of Clinical Laboratory,the Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan People's Hospital,Qingyuan 511518,Guangdong,China;Department of Respiratory Medicine,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,Guangdong,China;Department of Clinical Laboratory, the Third Affiliated Hospital of Guangzhou Medical University,Guangdong 510150,Guangzhou,China)
出处
《检验医学》
CAS
2019年第7期577-582,共6页
Laboratory Medicine
基金
广东省医学科研基金（B2019187)
关键词
碳青霉烯酶
多位点序列分型
耐药性
肺炎克雷伯菌
阴沟肠杆菌
Carbapenemase
Multilocus sequence typing
Drug resistance
Klebsiella pneumoniae
Enterobacter cloacae
