摘要
目的调查对碳青霉烯酶类抗菌药物耐药肺炎克雷伯菌的分子机制及其同源性,为新生儿感染的预防和监测提供参考依据。方法 5株肺炎克雷伯菌分离自2015年1-2月新生儿病房患儿吸痰标本;用法国生物梅里埃公司VITEK-2Compact系统对细菌进行鉴定和药敏;菌株产碳青霉烯酶的筛选是采用改良Hodge和金属酶试验;PCR和产物测序法检测以及确认菌株携带的超广谱β-内酰胺酶、AmpC酶和碳青霉烯酶耐药基因;脉冲场凝胶电泳分析细菌的同源性;质粒接合试验分析质粒的特性。结果除了氨曲南以外,5株肺炎克雷伯菌对二、三代头孢菌素和碳青霉烯类抗菌药物均耐药,且Hodge试验和金属酶试验均呈现阳性;每一株菌均携带blaNDM-1、blaCMY-6和blaDHA-1基因;脉冲场凝胶电泳显示5株菌的带型完全相同;质粒接合试验显示供体菌将携带blaNDM-1的质粒成功转移到受体菌。结论经检索,携带blaNDM-1、blaCMY-6和blaDHA-1基因的肺炎克雷伯菌在新生儿中的聚集流行为国际上首次报道,应加强医院感染的监测、预防和控制。
OBJECTIVE To investigate the molecular mechanisms and homology of carbapenem-resistant Klebsiella pneumoniae so as to provide guidance for prevention and surveillance of neonatal infections.METHODS Totally 5strains of K.pneumoniae were isolated from the sputum specimens that were obtained from neonatal ward children from Jan to Feb,2015,then the strains were identified by using VITEK-2Compact system of BioMérieux,and the drug susceptibility testing was conducted.The carbapenemase-producing strains were screened out by means of modified Hodge test and metallo-beta-lactamases test.The drug resistance genes encoding the extended-spectrumβ-lactamases（ESBLs）,AmpC enzyme,and carbapenemase were detected by using PCR and product sequencing method,the homology of the strains was determined through pulsed-field gel electrophoresis（PFGE）,and the characteristics of the plasmids were analyzed by means of plasmid conjugation test.RESULTS All of the 5strains of K.pneumoniae were resistant to the second,third generation cephalosporins and carbapenems except for aztreonam,and both the Hodge test and metallo-beta-lactamases test showed positive;each strain harbored bla NDM-1,blaCMY-6,and blaDHA-1gene;the PFGE revealed that the genotypes of the 5strains were completely the same;the plasmid conjugation test showed that the donor strains successfully transferred the plasmid bla NDM-1into the recipient strains.CONCLUSION Upon the retrieval,the gathered prevalence of the K.pneumoniae harboring the blaNDM-1,blaCMY-6,and blaDHA-1gene in neonates has been reported for the first time in the world,and it is necessary to strengthen the surveillance,prevention,and control of nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第10期2357-2360,共4页
Chinese Journal of Nosocomiology
基金
山东省科技攻关基金资助项目(2009GG10002057)
青岛开发区重点科技发展基金资助项目(2013-1-82)
