肺炎克雷伯菌及大肠埃希菌产KPC酶的检测研究

目的了解肺炎克雷伯菌及大肠埃希菌产KPC酶的情况和耐药关系。方法收集2007年3月至2008年10月临床分离的肺炎克雷伯菌及大肠埃希菌681株，采用KB纸片法进行药敏试验，以亚胺培南，美罗培南，厄他培南为检测药物，筛选出碳青霉烯类耐药菌株，采用改良的Hodge试验、聚合酶链反应（PCR）扩增检测细菌产KPC酶及基因分型。结果在491大肠埃希菌株和190肺炎克雷伯菌株中，对碳青霉烯类耐药的大肠埃希菌6株，肺炎克雷伯杆菌6株。进行Hodge试验，12株菌全部阴性，聚合酶链反应（PCR）扩增没出现目的基因片段。结论在12株对碳青霉烯类抗生素耐药的细菌中未发现产KPC酶的菌株。据国内的同类研究报道，目前我国主要以产KPC-2酶为主，而且产KPC酶存在地域性差异，课题研究显示本区域暂时没发现产KPC酶的菌株，有待进一步监测研究。

The analysis on the detection of and Klebsiella pneumoniae KPC type carbapenemase produced by Escherichia coli

Objective To investigate KPC type carbapenemase production in clinical isolates of Escherichia coli and Klebsiella pneumoniae in Guangzhou. Method To screen carbapenems resistance strains of Klebsiella pneumoniae and Escherichia coli with KB disk test,using imipenem,meropenem and ertapenem. To detect KPC-Enzyme with the modified Hodge test and PCR. Result A total of 491 clinical isolates of Escherichia coli and 190 clinical isolates of Klebsiella pneumoniae were collected from Mar 2007 to Oct 2008, and 6 isolates of Escherichia coli and 6 isolates of Klebsiella pneumoniae were resistant to carbapenems. Both Hodge test and KPC encoding genes were negative in all of the 12 isolates Conclusion No KPC-2 produced isolates was detected in this survey according to previous report in China, KPC-2 enzyme was mainly found in limited areas.