中国肺炎克雷伯菌碳青霉烯类抗生素耐药现状和流行病学分析

目的研究中国肺炎克雷伯菌对碳青霉烯类抗生素的耐药性及碳青霉烯酶在肺炎克雷伯菌中的分布。方法采用琼脂稀释法进行药敏实验;用PCR扩增和测序检测携带碳青霉烯酶基因的菌株;通过改良霍奇试验(MHT)和亚胺培南/EDTA双纸片协同试验(DDST)进行产碳青霉烯酶表型检测;利用PFGE及MLST对产酶菌株做流行病学分析。结果与结论产碳青霉烯酶肺炎克雷伯菌的亚胺培南MIC处于较低水平;KPC-2和IMP-4为本研究发现的主要酶型;肺炎克雷伯菌IMP的遗传背景较为复杂。

Current prevalence and epidemiologic analysis of carbapenem resistant of Klebsiella pneumoniae in China

Objective To investigate resistance of Klebsiella pneumoniae against carbapenems and overall distribution of different carbapenemases.MethodsAgar dilution was employed to test susceptibility and PCR amplification/sequencing was used to detect carbapenemase genes.Modified Hodge test(MHT) and imipenem/EDTA double disk synergy test(DDST) were used to determine phenotypes.Epidemiologic survey was conducted by means of PFGE and MLST.Results and ConclusionMost carbapenemase-producing strains demonstrate a lower MIC against impenems.KPC-2 and IMP-4 are dominant carbapenemases in Klebsiella pneumoniae in China.IMP carbapenemases may have a more complex genetic environment.