广西医学2024，Vol.46Issue(4)：543-550,8.DOI:10.11675/j.issn.0253-4304.2024.04.14
外科ICU与内科ICU碳青霉烯耐药肺炎克雷伯菌耐药性、碳青霉烯酶基因检测及流行病学研究
Carbapenem-resistant Klebsiella pneumoniae drug resistance,carbapenemase genetic test and epidemiological study in Surgical ICU versus Medical ICU
摘要
Abstract
Objective To analyze the kinship relation between carbapenem-resistant Klebsiella pneumoniae(CRKP)drug resistance,common carbapenemase genes and their strains in Surgical ICU versus Medical ICU.Methods CRKP non-duplicate strains isolated and validated in Surgical ICU and Medical ICU of a class Ⅲ hospital from January 2019 to December 2020 were collected,and drug sensitivity test was performed on strains by employing automatic instrument method.The carbapenemase phenotype was detected by using the mCIM combined with eCIM test,and the carbapenemase genes were detected through the PCR technique combined with DNA sequencing.The homology analysis was performed on carbapenemase-positive strains by the application of the multilocus sequence typing(MLST)method.Results A total of 15 strains of CRKP were collected,therein there were 8 strains in Surgical ICU and 7 strains in Medical ICU.CRKP strains exhibited high drug resistance to most clinical antibacterial agents,and only maintained high sensitivity to tigecycline.Through mCIM combined with eCIM test and PCR validation,a total of 14 CRKP strains carried carbapenemase genes,of which 7 strains only carried KPC-2 gene,mainly from Medical ICU,and 5 strains only carried NDM-5 gene,which were from Surgical ICU.One strain carrying KPC-2 gene and concomitant rare metalloenzyme gene was from Medical ICU,and one strain carrying NDM-1 gene and concomitant OXA-181 gene was derived from Surgical ICU.The results of MLST revealed that CRKP strains isolated from ICU of hospital were 3 sequence types of ST11,ST15,and ST16.The dominant sequence of Medical ICU was ST1 1(6/6),all carrying KPC-2 gene,and the dominant sequence of Surgical ICU was ST15(5/8),mainly carrying NDM-5 gene.Conclusion CRKP strains isolated from Surgical ICU and Medical ICU in hospital exert high drug resistance,and there are differences in drug resistance genes and dominant epidemic strains carried by CRKP strains.It is necessary to strengthen surveillance and epidemiological study of multidrug-resistant bacteria,and timely adopt effective treatment regimen and prevention and control strategies to prevent emergence and spread of drug-resistant strains.关键词
肺炎克雷伯菌/重症监护室/耐药性/碳青霉烯酶基因/多位点序列分型Key words
Klebsiella pneumoniae/Intensive Care Unit/Drug resistance/Carbapenemase gene/Multilocus sequence typing分类
医药卫生引用本文复制引用
李秋香,金静,梁宏洁,黄鑫,林青,蒋诚传,李泰阶..外科ICU与内科ICU碳青霉烯耐药肺炎克雷伯菌耐药性、碳青霉烯酶基因检测及流行病学研究[J].广西医学,2024,46(4):543-550,8.基金项目
广西高校中青年教师科研基础能力提升项目(2021KY0121) （2021KY0121）
广西南宁市武鸣区科学研究与技术开发计划项目(20200216) （20200216）
广西壮族自治区中医药管理局自筹经费科研课题(GZZC2020208) （GZZC2020208）
