摘要
目的探究肺炎克雷伯菌对碳青霉烯类抗菌药物耐药的分子机制。方法通过Carba NP确证试验检测碳青霉烯酶表型;PCR扩增碳青霉烯酶基因,质粒介导AmpC酶基因,超广谱β-内酰胺酶基因;采用多序列位点分型(MLST)对菌株进行遗传相关性分析。结果 50株耐破青霉烯肺炎克雷伯菌中,42株PCR扩增KPC-2阳性,1株NDM-1P阳性,其余7株未检测到碳青霉烯酶基因;产KPC-2肺炎克雷伯菌相关耐药基因的携带率为:bla CTX-M 21.5%,bla SHV 42.9%,bla TEM 69.1%和bla DHA4.8%;MLST结果显示42株KPC-2阳性菌株中,37株为ST11型。结论 KPC-2的产生是肺炎克雷伯菌对碳青霉烯类抗菌药物耐药的主要机制,且该院存在着ST11产KPC-2肺炎克雷伯菌的暴发流行。
Objective To explore the molecular mechanisms of carbapenem-resistant Klebsiella pneumoniae. Methods Carba NP confirmatory test were used to detect carbapenemases. Carbapenemase genes, ESBL genes and plasmid-mediated AmpC genes were amplified by polymerase chain reaction （PCR）. The genetic correlation analysis was carried out by using multiple sequence type （MLST）. Results 42 out of the 50 carbapenem-resistant Klebsiella pneumoniae strains were KPC-2-positive strains, 1 strain was positive for NDM-1, the other 7 strains were not detected for any carbapenemase genes. The percentages of KPC-2-positive Klebsiella pneumoniae with the bta CTX-M,bla SHV,bla TEM,bla DHA were 21.5% ,42.9% ,69.1% and 4.8 % respectively. The results of MLST showed that 37 out of 42 KPC-2 positive strains were ST11. Conclusion The production of KPC-2 is the main mechanism of Klebsiella pneumoniae resistance to carbapenem and there is an outbreak of STll KPC-2 Klebsiella pneumoniae in this hospital.
出处
《现代检验医学杂志》
CAS
2017年第3期112-114,共3页
Journal of Modern Laboratory Medicine
基金
基金项目:南京市医学科技发展资金(ZKX13028)
