摘要
从临床医院一患者痰液中分离出一株病原菌,采用全自动快速生物质谱检测系统鉴定该菌株为肺炎克雷伯菌。用标准纸片扩散法检测该菌株对头孢他啶、环丙沙星、呋喃妥因、复方新诺明、阿米卡星、哌拉西林、亚胺培南、美罗培南、厄他培南的耐药性,进行m CIM表型筛选试验和采用PCR法扩增碳青霉烯酶基因bla_(KPC-2),bla_(BIC),bla_(IMP),bla_(AIM),bla_(GIM),bla_(NDM),bla_(DIM),bla_(SME),bla_(OXA-48)和外膜孔蛋白基因bla_(Ompk-35),bla_(Ompk-36),最后对该菌株进行多位点序列分型分析。结果显示该菌株为多重耐药菌株,仅对阿米卡星敏感,对其他8种药物耐药。该菌株的m CIM表型筛选试验结果为阳性,通过PCR进一步鉴定该菌株携带1个耐药相关基因bla_(KPC-2),且外膜孔蛋白基因未发生片段缺失。该菌株的MLST分型为ST11。该研究为肺炎克雷伯菌的临床用药和治疗提供一定的参考依据。
A strain of pathogenic bacteria was isolated from the sputum of a patient in a clinical hospital,and it was identified as klebsiella pneumoniae by automatic rapid biological mass spectrometry detection system.Its resistance to ceftazidime,ciprofloxacin,nitrofurantoin,trimethoprim-sulfamethoxazole,amikacin,piperacillin,imipenem,meropenem and ertapenem was detected by standard disk diffusion method.At the same time,m CIM phenotype screening test was carried out and PCR method was used to amplify carbapenemase genes bla_(KPC-2),bla_(BIC),bla_(IMP),bla_(AIM),bla_(GIM),bla_(NDM),bla_(DIM),bla_(SME),bla_(OXA-48) and outer membrane porin genes blaOmpk-35and blaOmpk-36.Finally,its molecular typing was analyzed by multi-locus sequence typing.The results showed that the strain was a multi-drug resistant strain,which was only sensitive to amikacin and resistant to other eight drugs.The results of m CIM phenotypic screening test were positive,and PCR analysis showed that it carried a drug-resistance-related gene bla_(KPC-2),and fragment deletion was not found in the outer membrane porin genes.The strain was identified as ST11 by MLST molecular typing.This study provides a reference for the clinical medication and treatment of klebsiella pneumoniae.
作者
林德
李斯彦
谢海柔
赵淑芳
LIN De;LI Siyan;XIE Hairou;ZHAO Shufang(Clinical Laboratory,The First Affiliated Hospital of Lishui University,Lishui 323000,Zhejiang;Faculty of Medicine,Lishui University,Lishui 323000,Zhejiang)
出处
《丽水学院学报》
2022年第2期60-66,共7页
Journal of Lishui University
基金
浙江省教育厅一般科研项目“肺炎克雷伯菌对碳青霉烯类抗生素耐药机制研究”(Y201839774)
浙江省公益技术应用研究项目“生态农业之石蛙烂皮病治疗新对策”(LGN20C190005)。
