耐碳青霉烯肺炎克雷伯菌耐药率及同源性分析

目的分析耐碳氢酶烯肺炎克雷伯菌的耐药基因及流行病学特征。方法收集2018年1-8月临床分离出的14株耐碳氢酶烯类肺炎克雷伯菌，使用VITEK Compact微生物系统进行菌株鉴定和药敏试验，改良Hodge试验检测碳青霉烯酶，PCR试验检测耐药基因，肠杆菌科基因间重复序列聚合酶链反应（ERIC-PCR）分析菌株同源性。结果14株耐碳氢酶烯类肺炎克雷伯菌对青霉素类、碳青霉烯类、氨曲南和头孢菌素类等抗菌药物表现出较高的耐药性。11株肺炎克雷伯菌的碳青霉烯酶表型阳性，PCR检测发现12株肺炎克雷伯菌KPC-2基因阳性，14株肺炎克雷伯菌根据ERIC-PCR结果分成3型，其中A型为主，集中在ICU病房和神经外科。结论耐碳氢酶烯类肺炎克雷伯菌表现为严重的多重耐药性，以产生KPC酶和A型为主。

Analysis of drug resistance rate and homology of carbapenem-resistant Klebsiella pneumoniae

ObjectiveTo analyze the drug-resistant genes and epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae.MethodsFourteen strains of carbapenem-resistant Klebsiella pneumoniae were collected from January to August 2018, and the strain identification and drug susceptibility test were implemented using the VITEK Compact system.The modified Hodge test was used to detect the carbapenems, the PCR test was used to detect the drug-resistant genes, and the homology of the strains was analyzed using intergene repeated sequence polymerase chain reaction(ERIC-PCR).ResultsFourteen strains of carbapenem-resistant Klebsiella pneumoniae were highly resistant to penicillins, carbapenems, aztreonam and cephalosporins.Eleven strains of Klebsiella pneumoniae were positive in the modified Hodge test.The positive KPC-2 gene in 12 strains of Klebsiella pneumoniae were identified by PCR.The 14 strains could be classified into 3 genotypes, the type A was main, which was mainly isolated from ICU and neurosurgery.ConclusionsThe carbapenem-resistant Klebsiella pneumoniae shows the severe multi-drug resistance, mainly producing KPC enzyme and type A.