检验医学与临床2017，Vol.14Issue(23)：3438-3440,3443,4.DOI:10.3969/j.issn.1672-9455.2017.23.006
碳青霉烯耐药肺炎克雷伯菌的耐药机制与同源性分析
The analysis of resistance and homology for carbapenem resistant Klebsiella pneumonia
摘要
Abstract
Objective To analyze the clinical distribution,resistance phenotype,resistance gene and homology of carbapenem resistant Klebsiella pneumoniae (CRKPN),and provide laboratory evidence for clinical rational use of antibiotic and reduced the outbreak of nosocomial infections.Methods CRKPN isolates were collected from Xuanwu hospital from January 2015 to June 2016.The resistance rates and distribution were statistically analyzed using Whont5.6 software.The screening carbapenemase phenotypes was performed by Hodge test and carbapenem inactivation method(CIM) phenotypic screening test.PCR was used to detect the corresponding resistance gene(KPC,TEM,IMP,OXA48,DHA,VIM,NDM) and the homology analysis was by mass spectrometry technology.Results Total of 50 CRKPN strains were isolated in the hospital,accounted for 28.1％(50/178).All of the 50 strains of CRKPN showed high resistance to commonly used antimicrobial agents.The positive rates were 84.0％ (42/50) for Hodge test and CIM test,of which 82.0 ％ (41/50) were positive with two methods.The positive rate of blaKPc was the highest for 82.0 ％ (41/50),and that of other genes was 14.0％ for DHA,6.0％ for NDM,20.0％ for IMP,12.0％ for VIM,52.0％ for TEM and 2.0％for OXA48.In addition,36.0％ (18/50) of the three resistant genotypes and 26.0％ (13/50) of the two resistant genotypes were found in one isolate,and 10.0％ (5/50) of strains did not detect any drug resistance gene.Mass spectrometric classification showed two groups of A1(42.0％),A2(25.5％) and B(33.3％).Conclusion The positive rate of CRKPN is high,and resistant gene is mainly of KPC-2.Type A is the main prevalent strain of homology analysis by MS.关键词
碳青霉烯类抗菌药物/肺炎克雷伯菌/耐药基因/同源性Key words
carbapenem antibiotics/Klebsiella pneumoniae/resistance gene/homology引用本文复制引用
曹敬荣,于跃,陈典典,王岩,闵嵘,王培昌..碳青霉烯耐药肺炎克雷伯菌的耐药机制与同源性分析[J].检验医学与临床,2017,14(23):3438-3440,3443,4.基金项目
首都医科大学校长基金(2016JYY96). （2016JYY96）
