耐亚胺培南的肺炎克雷伯菌碳青霉烯酶基因检测及其同源性分析

目的 了解南京市鼓楼医院碳青霉烯酶在耐亚胺培南的肺炎克雷伯菌中的分布情况,并进行其同源性分析.方法 收集耐亚胺培南的肺炎克雷伯菌34株,K-B纸片法测定菌株对药物的敏感性;采用改良Hodge试验及EDTA协同试验进行A,B类碳青霉烯酶初筛试验;PCR法扩增碳青霉烯酶基因并进行序列分析,ERIC-PCR后进行同源性分析.结果 34株肺炎克雷伯菌对β-内酰胺类抗生素呈现泛耐药现象,耐药率达100％,仅对丁胺卡那、复方新诺明、左氧氟沙星敏感性相对较高,分别为17.6％,50％和23.5％.ERIC分析结果显示34株菌株主要分为两型,其中A型27株,B1型2株,B2型5株.结论 南京市鼓楼医院的肺炎克雷伯菌对碳青霉烯类抗生素耐药的首要原因是产KPC-2酶.

Carbapenemase Gene Detection and Homology Analysis of Imipenem-resistant Klebsiella Pneumoniae

Objective To study the distribution and homology analysis of acquired carbapenemase gene in imipenem-resistantstrains of Klebsiella pneumoniae in Nanjing Drum Tower Hospital. Methods 34 strains of imipenem-resistant Klebsiellapneumoniae were collected. Antibiotics＇ sensitivity was tested by K-B method. Modified Hodge test and EDTA collaborativeexperiment were used to detect carbapenemase phenotype. PCR amplified carbapenem gene and sequenced analysis, ERICamplification electrophoresis for homology analysis. Results 34 stains of Klebsiella pneumoniae were multi-resistance to 13-lactam antibiotics, only amikaein, trimethoprim sulfamethoxazole, levofloxacin sensitivity was relatively high. In the 34strains,all were positive in modified Hodge test and none was positive in EDTA synergy test. All were carried KPC-2 gene.The result of ERIC showed that 34 strains were divided into two types,of which 27 type A,B1 type 2 and B2 type 5. Conclu-sion KPC-2 gene was the major carbapenemase in imipenem-resistant Klebsiella pneumoniae in Nanjing Drum TowerHospital.