携带blakpc-2型碳青霉烯酶基因泛耐药肺炎克雷伯菌医院内感染暴发的病原学分析

目的 了解引起医院内感染暴发临床分离的泛耐药肺炎克雷伯菌(Kpn)KPC型碳青霉烯酶基因blaKPC存在状况.方法 2008年11月至2009年7月从住院患者中分离19株泛耐药Kpn,采用改良Hodge试验检测菌株产碳青霉烯酶情况,采用PCR及序列分析的方法分析blaKPC基因.结果 19株泛耐药Kpn改良Hodge试验结果均阳性、blaKPC基因阳性率为100.0%,序列分析确认均为blaKPC-2亚型,其中HZ001号菌株(原始编号HZ9871)blaKPC-2基因序列已登录GenBank,注册号为GU086225.结论 临床分离的泛耐药Kpn均携带blaKPC-2基因,而产KPC-2型碳青霉烯酶是分离菌株对碳青霉烯类抗生素耐药的主要原因.

Study on pan-resistant Klebsiella pneumoniae harboring blakpc-2 type carbapenemase gene from a hospital outbreak in Huzhou,Zhejiang

Objective To investigate the status of genotype of the KPC(Klebsiella pneumoniae carbapenemase)-encoding genes in Pan-resistant K. Pneumoniae, isolated from the 98th Hospital of People' s Liberation Army, Huzhou district, Zhejiang province, China. Methods 19 strains of Pan-resistant K. Pneumoniae were isolated from the inpatients between November, 2008 and July,2009. Phenotypic confirmatory test for suspected carbapenemases production were carried out by Modified Hodge test. Carbapenemase gene of blaKPC was analyzed by PCR and verified by DNA sequencing. Results In 19 strains of K. Pneumoniae, the positive rates of Modified Hodge test and gene of blaKPC were both 100.0%. These genes all belonged to blaKPC-2 subtype confirmed by nucleotide sequence analysis. Among them, the blaKPC-2 gene sequence of the HZ001 strain (its original serial number was HZ9871 ) had been registered in GenBank (GenBank Accession Number: GU086225).Conclusion All of the Pan-resistant K. Pneumoniae isolated from the inpatients harbored blaKPC-2 type carbapenemases gene and causing an outbreak in a hospital. Carbapenemases that producing type KPC-2 might be the major reason which causing the resistance to Carbapenems antibiotics.