摘要
目的明确丽水市中心医院产KPC酶肺炎克雷伯菌的分子流行病学特征,为临床抗感染治疗提供实验依据。方法收集2011年3月至2015年10月丽水市中心医院分离的碳青霉烯类抗生素耐药肺炎克雷伯菌(CR-KP)。采用Vitek2-compact系统鉴定菌株并联合纸片扩散法(K-B法)检测其药敏,改良Hodge试验检测碳青霉烯酶;PCR法扩增KPC基因,测序后利用BLAST比对确定基因型;肠杆菌科基因间重复序列分型法(ERIC-PCR)联合多位点序列分型(MLST)鉴定菌种同源性;进而探讨产KPC酶肺炎克雷伯菌的分子流行病学特征。结果共收集到70株CR-KP,其中68株改良Hodge试验阳性,扩增产物测序结果均为blaKPC-2基因。ERIC-PCR结果显示,70株KPC型肺炎克雷伯菌分为A、B、C、D、E5个克隆群分别为63株(90.0%)、3株、2株、1株、1株;MLST分成6个ST型,其中ST11型63株(90.0%),ST35型2株,ST1型2株,ST592、ST1883、ST494型均1株。结论丽水市中心医院碳青霉烯类耐药肺炎克雷伯菌的主要克隆群为ST11型,是我院流行感染的主要原因。
Objective To identify the genotypes of KPC- producing Klebsiella pneumoniae isolated from Lishui CentralHospital. Methods Seventy clinical strains of carbapenem- resistant Klebsiella pneumoniae (CR- KP) were isolated from LishuiCentral Hospital from March 2011 to October 2015. The strains were identified with Vitek2- compact system, and drug sensitivitywas detected with disk diffusion method (K- B method) . The modified Hodge test was used to detect carbapenemase; KPC genewas amplified with PCR, and BLAST was used to determine the genotype after the sequencing. Enterobacteriaceae intergenicrepetitive sequence classification (ERIC- PCR) and multiple loci sequence classification (MLST) were used to identify thehomology of strains. Results Among 70 strains of CR- KP, 68 strains were modified Hodge test positive and confirmed to carryblaKPC- 2 gene. ERIC- PCR showed that there were 63 strains of group A (90.0%), 3 of group B, 2 of group C, 1 of group D and 1of group E. MLST showed that there were 63 strains of ST11(90.0%) , 2 of ST35, 2 of ST1, 1 of ST592, 1 of ST1883 and 1 of ST494,respectively. Conclusion ST11 is the main genotype of KPC- producing Klebsiella pneumoniae isolated from Lishui Central Hospital.
出处
《浙江医学》
CAS
2017年第24期2261-2264,共4页
Zhejiang Medical Journal
基金
浙江省丽水市公益性技术应用研究项目(2014GYX023)
关键词
碳青霉烯酶
肺炎克雷伯菌
肠杆菌科重复序列
多位点序列分型
分子流行病学
Carbapenemase
Klebsiellapneumoniae
Enterobacteriaceae intergenic repetitive sequence
Multipleloci sequence
Molecular epidemiology
