摘要
目的对耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药基因的携带情况与分子流行病学特征进行分析,为研究细菌耐药提供参考依据。方法收集2016年2月至2017年2月临床分离到的37株CRKP菌株,采用微量肉汤稀释法检测菌株药物敏感性;改良霍奇实验及亚胺培南-EDTA协同法检测碳青霉烯酶表型;PCR检测KPC-2、VIM、NDM-1、OXA-48等耐药基因,进行测序及网上比对确定基因型;采用多位点序列分型(MLST)对菌株进行遗传相关性研究,MEGA软件构建进化树、eBURST软件分析亲缘关系。结果 37株菌株对常用抗菌药物耐药性均在90%以上。所有菌株均检测到KPC-2基因,3株同时携带NDM-1基因,其余基因均为阴性。MLST分型为ST11有25株,ST524 2株,ST789 4株,ST35、ST29、ST1066及ST244各1株,另外有1个新的ST型(2株)已被PubMlst数据库确认收录并命名为ST2792。ST11型组及非ST11型组在年龄、性别、感染途径、抗菌药物使用情况等方面差异无统计学意义(P<0.05)。结论携带KPC-2基因是导致细菌对碳青霉烯类抗菌药物耐药的主要原因,ST11型是最流行的克隆型。
Objective To analyze the drug resistance gene carrying situation of carbapenem-resistant Klebsiella pneumoniae （CRKP） and molecular epidemiological characteristics to provide a reference basis for studying the bacterial drug resistance. Methods A total of 37 clinically isolated strains of CRKP were collected from February 2016 to February 2017.The broth microdilution method was used to determine the strain drug susceptibility.The phenotypes of CRKP carbapenemases were detected by using the modified Hodge test and EDTA-imipenem synergistic method.The drug resistance genes of KPC-2,NDM-1 and OXA-48 were detected by PCR.The sequencing and internet comparison were performed for determining the genotype.The multilocus sequence typing （MLST） was adopted to conduct the genetic correlation study on the strains.The evolutionary trees were constructed by using the MEGA software and the genetic relationship was analyzed by using the eBURST software. Results The drug resistance to commonly used antibacterial drugs was over 90%.The KPC-2 gene was detected in all strains,3 strains simultaneously carried the NDM-1 gene,and other genes were negative.In MLST typing,25 strains were ST11,each 2 strains were ST524 and ST789,each 1 strain was ST35,ST29,ST1066 and ST244 respectively.Also a new ST type（2 strians） was confirmed by the PubMlst database and named as ST1792.The ST11 type group and non-ST11 type group had no statistical difference in the aspects of the age,sex,infection route and antibiotics use（ P 〈0.05）. Conclusion Carrying KPC-2 gene is the main cause leading to bacterial resistance to carbapenem and ST11 type is the most popular clone type.
出处
《重庆医学》
CAS
2018年第15期1977-1980,1985,共5页
Chongqing medicine
基金
国家自然科学基金资助项目(81660002)
关键词
克雷伯菌
肺炎
碳青霉烯类抗菌药物
耐药基因
多位点序列分型
分子流行病学
Klebsiella pneumoniae
carbapenems antibacterial drugs
drug resistance genes
multilocus sequence typing
molecular epidemiology
