69株碳青霉烯类耐药肺炎克雷伯菌耐药基因检测分析

目的了解耐碳青霉烯类抗生素的肺炎克雷伯菌耐药基因的携带情况。方法收集69株浙江省人民医院住院病人耐碳青霉烯的肺炎克雷伯菌株,改良Hodge试验进行KPC型碳青霉烯酶初筛检测,PCR法进行HSV、OXA-1群、OXA-2群、OXA-10群、GES、VEB、IMP、VIM、SME、KPC、IMI/NMC、NDM基因检测,并对部分阳性基因进行测序。结果 69株肺炎克雷伯菌改良Hodge试验阳性48株,阳性率63.8%。PCR检测结果为56株(81.2%)携带KPC基因,60株(87%)携带HSV,20株(29.0%)携带OXA-3基因;3株(4.35%)肺炎克雷伯菌携带OXA-1基因。对KPC基因测序结果为KPC-2亚型。结论本次检测的耐碳青霉烯类肺炎克雷伯菌携带KPC-2基因为主,应加强院感监测和预防。

Detection and analysis of drug resistance genes in 69 carbapenem resistance Klebsiella pneumoniae strains

Objective To understand the drug resistance genes carried on carbapenem resistance Klebsiella pneumoniae strains. Methods 69 carbapenem resistance K. pneumoniae strains were collected from inpatients in Zhejiang Provincial People＇ s Hospital, modified Hodge test was used to screen KPC-carbapenemase, HSV, OXA-lgroup, OXA-2 group, OXA-10 goup, GES, VEB, IMP, VIM, SME, KPC, IMI/NMC and NDM gene were detected with PCR and some amplified products were analyzed by sequencing. Results Of 69 carbapenem resistance K. pneumoniae strains, 48 strains （63.8%） were positive for modified Hodge test, KPC gene were detected in 56 strains （81.2%）, HSV, OXA-3 and OXA-1 were detected in, 60 （87%）, 20 （29.0%）and 3 （4.35%）strains respectively. Sequence analysis revealed that the detected KPC genes were KPC-2. Conclusion KPC-2 gene was the mainly carried gene in carbapenem resistance K. pneumoniae strains, and more attention should be paid to hospital infection monitor and prevent the dissemination of these strains.