利用GeneXpert法检测耐碳青霉烯类肠杆菌科细菌耐药基因及耐药性分析

Detection of Carbapenem-resistant genes in Enterobacteriaceae using the GeneXpert molecular diagnostic system and the resistance analysis

目的利用GeneXpert Carba-R全自动病原体快速检测系统检测碳青霉烯类耐药肠杆菌科细菌的耐药基因,了解该院耐碳青霉烯类肠杆菌科细菌(CRE)耐药情况和耐药基因分布,为了解临床CRE感染趋势提供依据。方法采用回顾性调查方法,收集2016年3月至2017年10月分离自非呼吸道标本的141株耐碳青霉烯类肠杆菌科菌株。结果肺炎克雷伯杆菌114株,大肠埃希菌13株,阴沟肠杆菌8株,产气肠杆菌2株,弗氏枸橼酸杆菌3株,魏氏柠檬酸杆菌1株。bla KPC 103株,bla NDM 22株,bla OXA-485株,含两种及两种以上耐药基因12株。结论GeneXpert Carba-R全自动病原体快速检测系统能快速检测出耐碳青霉烯类肠杆菌的耐药基因,耐碳青霉烯类抗菌药物的细菌对多种抗菌药物同时耐药,检出的耐药基因型为KPC、NDM、OXA-48及IMP。含不同耐药基因的肠杆菌科细菌其耐药情况不同。

Objective To detect Carbapenem resistant genes in Enterobacteraceae by GeneXpert Carba-R molecular diagnostic system,in order to investigate the drug resistance and the distribution of resistance genes of CRE in a hospital and provide a basis for clinical control and prevention of CRE infection.Methods By means of retrospective survey,141 strains of CRE,from March 2016 to October 2017,isolated from non-respiratory specimens are collected.Results 114 strains of Klebsiella pneumoniae,13 strains of Escherichia coli,8 strains of Enterobacter cloacae,2 strains of Enterobacter aerogenes,3 strains of Citrobacter freundii and 1 strain of Citrobacter westermani.bla KPC 103 strains,bla NDM 22 strains,bla OXA-485 strains,12 strains contain two or more resistance genes,9 strains detect no resistance gene.Conclusion GeneXpert Carba-R molecular diagnostic system provide a rapid and accurate detection of Carbapenem resistant genes in Enterobacteraceae.Enterobacteriaceae resistant to Carbapenem antibiotics are resistant to many kinds of antibiotics.The main resistance genotypes are KPC,NDM,OXA-48 and IMP.The drug resistance of Enterobacteriaceae bacteria with different resistance genes vary different.