产ESBLs肺炎克雷伯菌的基因型和耐药性研究

Study on Genotype and Drug Resistance of ESBLs-producing Klebsiella pneumoniae

超广谱β-内酰胺酶(extended spectrumβ-lactamase,ESBLs)与细菌耐药性密切相关,为了揭示产ESBLs肺炎克雷伯菌的基因型和耐药性,本研究在2017年1月至2018年9月期间,共检测了466例肺炎克雷伯菌感染的患者标本,并分析了产ESBLs肺炎克雷伯菌的基因型和耐药性。研究结果显示,466例患者中共检出562个肺炎克雷伯菌菌株。其中,呼吸内科的检出数最多(212株,37.72%),其次为重症监护科(106株,18.86%)。对于不同标本来源,痰液中检出菌数最多(331株),占总数的58.90%。562株肺炎克雷伯菌中共检测出237株产ESBLs(42.17%)。产ESBLs肺炎克雷伯菌对阿莫西林(89.03%)、替卡西林(87.34%)、氨苄西林(81.43%)的耐药率最高;而对替加环素(9.28%)、阿米卡星(6.75%)、亚胺培南(1.27%)和美罗培南(0.84%)的耐药率最低。237株产ESBLs的肺炎克雷伯菌菌株中,53.59%扩增出CTX-M型,48.95%扩增出TEM型,40.93%增出SHV型。另外,237株产ESBLs的肺炎克雷伯菌菌株中,产两个及以上的ESBLs的菌株共111株(46.84%)。

Extended spectrumβ-lactamase(ESBLs)is closely related to bacterial resistance.This study aims to reveal the genotype and drug resistance of ESBLs-producing Klebsiella pneumoniae.From January 2017 to September 2018,a total of 466 specimens of Klebsiella pneumoniae infection were tested and the genotype and drug resistance of ESBLs-producing Klebsiella pneumoniae were analyzed.Studies showed that 562 ESBLs-producing Klebsiella pneumoniae strains were detected in 466 patients.Among them,the number of respiratory medicine department was the highest(212 strains,37.72%),followed by the intensive care unit(106 strains,18.86%).For different specimen sources,the number of bacteria detected in sputum was the highest(331 strains),accounting for 58.90%.A total of 237 strains of ESBLs(42.17%)were detected in 562 strains of ESBLs-producing Klebsiella pneumoniae.ESBLs-producing Klebsiella pneumoniae had the highest resistance rate to amoxicillin(89.03%),ticarcillin(87.34%),and ampicillin(81.43%),but had the lowest resistance rates to tigecycline(9.28%),amikacin(6.75%),imipenem(1.27%)and meropenem(0.84%).Among the 237 strains of ESBLs-producing Klebsiella pneumoniae,53.59%amplified CTX-M type,48.95%amplified TEM type,and 40.93%increased SHV type.In addition,among the 237 strains of ESBLs-producing Klebsiella pneumoniae,111 strains(46.84%)produced two or more ESBLs.