摘要
目的探讨血流感染中临床分离的耐碳青霉烯酶肠杆菌科细菌相关耐药基因及临床药物敏感性,为血流感染临床治疗和医院内感染控制提供依据。方法收集2016年1-12月南京医科大学第一附属医院血流感染分离的16株耐碳青霉烯酶肠杆菌科细菌,采用改良碳青霉烯酶检测试验(改良Hodge试验)检测碳青霉烯酶表型,采用PCR法检测碳青霉烯酶基因,采用微量肉汤稀释法测定最低抑菌浓度(MIC)。结果16株临床分离菌株中,12株为肺炎克雷伯菌,4株为大肠埃希菌。改良Hodge试验阳性率为87.50%(14/16)。全部菌株均携带肺炎克雷伯菌碳青霉烯酶(KPC-2)基因。全部菌株对亚胺培南、美罗培南、氨曲南耐药率为100.00%,对多黏菌素,替加环素灵敏度为100.00%。结论本次分离的肠杆菌科细菌所产碳青霉烯酶的基因型均为KPC-2,对于耐碳青霉烯酶的肠杆菌科细菌感染治疗可以应用替加环素和(或)多黏菌素联合其他药物联合治疗。临床医护人员应该加强耐碳青霉烯酶肠杆菌科细菌的感染控制监测,控制其在院内传播。
Objective To explore the drug-resistance genes and drug sensitivity of carbapenase resistant Enterobacteriaceae isolated clinically in bloodstream infection,and to provide a basis for the clinical treatment of bloodstream infection and control of hospital infection.Methods Sixteen strains of Enterobacteriaceae were isolated from the blood specimen of the First Affiliated Hospital of Nanjing Medical University from January to December,2016.Improvement Hodge′s test was used carbon alkene enzyme phenotypes.Polymerase chain reaction was used to detect drug-resistance genes and micro broth dilution method was used to determine the minimal inhibitory concentration.Results Twelve strains of sixteen clinical isolates were Klebsiella pneumoniae and four strains were Escherichia coli.The positive rate of improvement Hodge′s test was 87.50%(14/16).All strains carried Klebsiella pneumoniae carbapenamase(KPC-2)genes.The drug resistance rate of all strains to imipenem,meropenem and aztreonam was 100.00%,and the sensitivity to polymyxin and tigecycline was 100.00%.Conclusion The genotypes of carbapenems produced by the isolated Enterobacteriaceae bacteria were all KPC-2.For the treatment of carbapenase resistant Enterobacteriaceae infection,treatment scheme can be referred to tigecycline or polymyxin combination with other drugs.Clinical staffs should strengthen infection monitoring of carbapenem-resistant Enterobaeteriaceae in hospitals and control its spread in hospitals.
作者
陈建平
朱菁
黄旭
梅亚宁
CHEN Jianping;ZHU Jing;HUANG Xu;MEI Yaning(Department of Clinical Laboratory,the People′s Hospital of Liuhe,Nanjing,Jiangsu 211500,China;Department of Clinical Laboratory,Children′s Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;Department of Clinical Laboratory,the First Affiliated Hospital with Nanjing Medical University/Jiangsu Province Hospital,Nanjing,Jiangsu 210029,China)
出处
《检验医学与临床》
CAS
2020年第12期1715-1717,1722,共4页
Laboratory Medicine and Clinic
关键词
碳青霉烯酶耐药
肠杆菌科细菌
耐药基因
医院内感染
carbapenase resistance
Enterobacteriaceae
drug-resistance genes
hospital infection
