摘要
目的了解呼和浩特地区耐碳青霉烯类肠杆菌科细菌(CRE)的耐药性及耐药基因分布情况。方法以2014—2017年内蒙古医科大学附属医院分离的CRE为研究对象,采用Vitek-2 Compact全自动微生物系统进行鉴定和药敏试验,采用微量肉汤稀释法检测CRE菌株对亚胺培南和美罗培南的最小抑菌浓度(MIC),采用PCR法检测耐药基因携带情况。结果共分离CRE菌株71株,其中肺炎克雷伯菌39株(54.9%)、阴沟肠杆菌28株(39.4%)、大肠埃希菌4株(5.7%)。药敏结果显示,39株肺炎克雷伯菌对复方磺胺甲噁唑耐药率最低为48.8%(19株),对其他常规抗生素耐药率均高于80%;28株阴沟肠杆菌中,除1株对复方磺胺甲噁唑敏感外,对其他常规抗生素耐药率均为100%;4株大肠埃希菌对所有抗生素均耐药。71株CRE菌株对亚胺培南和美罗培南的MIC50值分别为128 μg/mL和64 μg/mL、MIC90值分别1 024 μg/mL和512 μg/mL;39株肺炎克雷伯菌对亚胺培南和美罗培南的MIC50值分别为512 μg/mL和128 μg/mL,MIC90值为1 024 μg/mL和256 μg/mL。PCR结果显示,KPC-2、NDM-1、SPM、OXA-48基因阳性率分别为56.33%(40/71)、33.80%(24/71)、7.04%(5/71)、7.04%(5/71),6株CRE同时检出2种以上耐药基因。结论呼和浩特地区CRE耐药情况严重,尤其是肺炎克雷伯菌,其对亚胺培南和美罗培南呈高水平耐药,KPC-2型是其耐药的主要原因。
Objective To investigate the resistance characteristics and gene distribution of carbapenem-resistant Enterobacteriaceae (CRE) in Hohhot. Methods The strains of CRE were collected from the Affiliated Hospital of Inner Mongolia Medical University from 2014 to 2017. The strains were identified by Vitek-2 Compact automated microorganism analysis system. The minimal inhibitory concentration (MIC) of imipenem and meropenem was detected by the microdilution method. The β-lactamase genes and integrin genes were detected by PCR. Results A total of 71 strains were isolated, including 39 strains (54.9%) of Klebsiella pneumonia, 28 stains (39.4%) of Enterobacter cloacae and 4 strains (5.7%) of Escherichia coli. The drug susceptibility in 39 strains of Klebsiella pneumoniae showed that the resistance rate to sulfamethoxazole was 48.8%(19/39), and the resistance rates to other antibiotics were higher than 80%. The drug susceptibility in 28 strains of Enterobacter cloacae showed that only 1 strain sensitive to cotrimoxazole, the resistance rates to other antibiotics were 100%. Four strains of Escherichia coli were resistant to all antibiotics. The drug test in 71 CRE strains showed that the MIC50 of imipenem and meropenem were 128 and 64 μg/mL;the MIC90 of imipenem and meropenem were 1 024 and 512 μg/mL, especially Klebsiella pneumonia showed MIC50 of 512 and 128 μg/mL, MIC90 of 1 024 and 256 μg/mL. Among 71 strains of CRE, the positive rates of KPC-2, NDM-1, SPM, OXA-48 grne were 56.33%(40/71), 33.80%(24/71), 7.04%(5/71), 7.04%(5/71), respectively, and 6 strains were detected more than two kinds of genes. Conclusions CRE in Hohhot is severe, especially in Klebsiella pneumonia that has the high levels of resistance to imipenem and meropenem, and KPC-2 gene is the main cause.
作者
王艳艳
韩艳秋
郭素芳
福泉
王俊瑞
Wang Yanyan;Han Yanqiu;Guo Sufang;Fu Quan;Wang Junrui(Clinical Laboratory,Affiliated Hospital of Inner Mongolian Medical University,Hohhot 010050,China)
出处
《国际流行病学传染病学杂志》
CAS
2019年第3期195-199,共5页
International Journal of Epidemiology and Infectious Disease
基金
2017年度内蒙古自治区高等学校青年科技英才支持计划(NJYT-17-B06).
关键词
肠杆菌科
碳青霉烯酶
肺炎克雷伯菌
阴沟肠杆菌
耐药性
Enterobacteriaceae
Carbapenem
Klebsiella pneumonia
Enterobacter cloacae
Drug resistance
