摘要
目的 探讨湖北省肺炎克雷伯菌(KP)高毒力荚膜血清分型及碳青霉烯酶耐药基因携带情况。方法 收集湖北省2019-2020年58家医院临床分离的疑似KP菌株,以基质辅助激光解吸飞行时间质谱仪初筛,全自动生化鉴定仪复核鉴定。采用微量肉汤稀释法进行药敏试验,多重PCR进行高毒力荚膜血清分型,PCR扩增法检测碳青霉烯酶耐药基因。结果 收集的326株疑似菌株均为KP,标本来源于体液(血液、胸腔积液、脑脊液、腹水)及其他部位的KP对三代头孢菌素、碳青霉烯类抗菌药物的药敏试验结果差异无统计学意义(P>0.05)。对碳青霉烯类抗菌药物耐药的KP检出率高达19.02%(62/326)。碳青霉烯酶耐药基因KPC检出率为10.74%(35/326),NDM为1.23%(4/326),其中2株同时携带KPC和NDM基因。高毒力荚膜血清分型以K2型为主,检出率为11.04%(36/326),其他检出率依次为K57型的5.21%(17/326)、K54型的1.84%(6/326),未检出K1型。有7株高毒力荚膜型KP同时携带KPC耐药基因。结论 湖北省KP对多种抗菌药物耐药且耐药率呈上升趋势,并出现了携带KPC耐药基因的高毒力KP,在临床诊疗中必须加强对耐碳青霉烯类KP的监测,结合细菌耐药性合理选择抗菌药物。
Objective To investigate the high virulence capsular serotyping and the carrying of carbapenemase resistance genes of Klebsiella pneumoniae(KP) in Hubei province.Methods The suspected KP strains clinically isolated from 58 hospitals in Hubei Province from 2019 to 2020 were collected, initially screened by matrix-assisted laser desorption time-of-flight mass spectrometer, and rechecked and identified by automatic biochemical identification instrument.Drug susceptible test was performed by micro-broth dilution method, and the high virulence capsular serotyping was performed by multiplex PCR,and carbapenemase resistance gene was detected by PCR amplification method.Results The collected 326 suspected strains were all KP,there were not statistically significant differences in the drug susceptible tests results of KP samples from body fluids(blood, pleural effusion, cerebrospinal fluid, ascites) and other parts of the three-generation cephalosporins and carbapenems(P>0.05).The detection rate of KP resistance to carbapenems was as high as 19.02%(62/326).The detection rate of KPC of carbapenemase resistance gene was 10.74%(35/326),and NDM was 1.23%(4/326),and 2 strains carried both KPC and NDM genes.The high virulence capsular serotyping was mainly K2 type, with a detection rate of 11.04%(36/326),and the other detection rates were 5.21%(17/326) of K57 type and 1.84%(6/326) of K54 type.K1 type was not detected.Seven strains KP with high virulence capsular also carried KPC resistance genes.Conclusion KP in Hubei Province is resistant to many kinds of antibiotics, and the drug resistance rate is on the rise, and highly virulent KP carrying KPC drug resistance genes has emerged.In clinical diagnosis and treatment, it is necessary to strengthen the monitoring of carbapenem-resistant KP,and rationally select antibiotics in combination with bacterial resistance.
作者
张雅婷
赵改婵
专行
朱明
戴莹
史静
李国明
ZHANG Yating;ZHAO Gaichan;ZHUAN Hang;ZHU Ming;DAI Ying;SHI Jing;LI Guoming(Institute of Health Inspection and Testing,Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China;School of Public Health Wuhan University,Wuhan,Hubei 430071,China;Department of Nosocomial Infection Management,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China;Department of Health Monitoring and Inspection,Xiangyang Center for Disease Control and Prevention,Xiangyang,Hubei 44102,China)
出处
《国际检验医学杂志》
CAS
2022年第22期2750-2754,共5页
International Journal of Laboratory Medicine
基金
湖北省襄阳市医疗卫生领域科技计划项目(2021YL42)。
