重症监护病房耐亚胺培南肺炎克雷伯菌耐药基因检测

摘要

Objective: To investigate the molecular epidemiology and mechanism of carbapenem resistance of Klebsiella pneumoniae from intensive care units ( ICU). Methods: Thirteen strains of Klebsiella pneumoniae with carbapenem resistance were isolated from ICU. The minimum inhibitory concentrations ( MIC) were detected by using agar-dilution, polymerase chain reaction( PCR) and cloning and sequencing of resistance genes were used to analyzed the resistant mechanism. Enterobacterial repetitive intergenic consensus-PCR was performed to analyze the molecular epidemiology. Results:The MICs of imipenem of 13 strains of Klebsiella pneumoniae were from 16 to 1024 μg/ml, which were blaKPC-2 and blaSHV using the PCR product cloning and sequencing method. Conclusions: Carbapenemase blaKPC-2 is the major factor of carbapenem resistance, and lactamase blaSHV participates multiple mechanisms of resistance.%目的:对重症监护病房(ICU)出现的13株耐亚胺培南肺炎克雷伯菌的分子流行病学及耐药机制进行研究.方法:从ICU分离到13株对亚胺培南耐药肺炎克雷伯菌,采用琼脂稀释法检测包括亚胺培南在内的5种抗菌药物最低抑菌浓度(MIC);用聚合酶链反应(PCR)及耐药基因克隆测序方法研究细菌的耐药机制;用肠杆菌基因间重复性一致性序列-PCR分析菌株的分子流行病学.结果:13株肺炎克雷伯菌亚胺培南的MIC为16～1 024 μg/ml;13株实验菌PCR产物克隆测序分析比对为blaKPC-2型和blaSHV型基因.结论:ICU连续出现13株耐亚胺培南肺炎克雷伯菌,KPC-2是引起细菌对亚胺培南耐药的主要原因,SHV型β-内酰胺酶同时参与多重耐药机制.