摘要
目的了解本院碳青霉烯耐药肺炎克雷伯菌(CRKP)的耐药机制及对常用抗菌药物的耐药性,为临床感染的控制提供依据。方法收集2015年-2017年佳木斯大学附属第一医院临床患者分离的CRKP,VITEK 2 Compact检测其对常用抗菌药物的敏感性;PCR方法扩增碳青霉烯酶基因(KPC、NDM、IMP-4、IMP-8、VIM-1、VIM-2、OXA-23、OXA-24、OXA-48、OXA-51、OXA-58)。结果共收集31株CRKP对多数β-内酰胺类药物高度耐药,对酶抑制剂复合制剂及一、三、四代头孢、碳青霉烯类药物的耐药率达90%以上。对氨基糖苷类药物庆大霉素、妥布霉素的耐药率较高,达80%以上。阿米卡星及左氧氟沙星的敏感率较高,达90%以上。29株KPC基因阳性,1株NDM-5阳性,2株IMP-4阳性。结论本院分离的CRKP耐药现象严重,产KPC型酶是本院CRKP的主要耐药机制,相关部门应积极采取感染控制及预防措施,避免耐药菌的进一步播散。
Objective To investigate the carbapenem resistant Klebsiella pneumoniae（CRKP） in our hospital and the mechanism of drug resistance to commonly used antimicrobial drug,so as to provide basis for clinical infection control. Methods The CRKP from clinical patients were collected from 2015 to 2017 in the First Affiliated Hospital of Jiamusi University,and VITEK2 Compact was used to detect the antimicrobial susceptibility of common antibacterials; and amplification of carbapenem genes was conducted by PCR（KPC,NDM,IMP-4,IMP-8,VIM-1,VIM-2,OXA-23,OXA-24,OXA-48,OXA-51,OXA-58）. Results Thirty one strains of CRKP were highly resistant to most β-lactam drugs,and the resistance rate to the enzyme inhibitor complex preparations and the first-generation,the third-generation,the fourth-generation carbapenems was over 90%. The resistance rate to aminoglycoside gentamicin and tobramycin was higher than 80%. Amikacin and levofloxacin had a higher sensitivity than 90%. 29 strains of KPC gene,1 strain of NDM-5,2 strains of IMP-4 were all positive.Conclusion The resistance of CRKP isolated in our hospital is severe. The KPC-producing enzyme is the main resistance mechanism of CRKP. Relevant departments should actively adopt infection control and preventive measures to avoid further spread of drug-resistant bacteria.
作者
宫雪
王勇
李慧玲
王宇超
张吉生
张晓丽
GONG Xue;WANG Yong;LI Hui-ling;WANG Yu-chao;ZHANG Ji-sheng;ZHANG Xiao-li(The First Affiliated Hospital of Jiamusi University,Jiamusi,Heilongfiang 154007,China)
出处
《中国卫生检验杂志》
CAS
2018年第15期1834-1836,1840,共4页
Chinese Journal of Health Laboratory Technology
基金
黑龙江省自然科学基金项目(D201224)
黑龙江省卫生计生委科研项目(2017-405)
佳木斯大学研究生科技创新项目(YM2016-056)
黑龙江省大学生创新创业项目(201710222001)
