碳青霉烯类耐药克雷伯菌属细菌的药物敏感性及同源性分析

摘要

Objective To investigate the resistance mechanism and epidemiology of carbapenem-resistant Klebsiella spp.,and to establish the pulsed-field gel electrophoresis(PFGE)typing database of carbapenem-resistant Klebsiella spp.,in order to provide the reference for rapidly source-tracking and controlling the bacterium spread at the outbreak of nosocomial infection.Methods Carbapenem-resistant Klebsiella spp.were collected,and the phenotypic and genetic features were detected by modified Hodge test and polymerase chain reaction(PCR),respectively.PFGE typing was performed for homology analysis.Results The main resistance mechanism of carbapenem-resistant Klebsiella spp.was Klebsiella pneumoniae carbapenemase (KPC )-producing,and there were 2 genotypes by PFGE typing,including genotype A(4 isolates)and genotype B(4 isolates).Conclusions KPC-producing is the main reason for carbapenem-resistant Klebsiella spp.in the hospital,and it is necessary to monitor the resistance and to strengthen the infection control.%目的：探讨碳青霉烯类耐药的克雷伯菌属细菌的耐药机制，了解获得性碳青霉烯类耐药克雷伯菌属细菌流行状况，建立克雷伯菌属细菌的脉冲场凝胶电泳（PFGE）分型数据库，以便在发生医院暴发流行时快速溯源，为控制该类细菌的传播提供技术支撑。方法收集碳青霉烯类耐药的克雷伯菌属细菌，用改良 Hodge 试验和聚合酶链反应（PCR）分别测定其表现型和基因型；用 PFGE 对其进行同源性分析。结果碳青霉烯类耐药的克雷伯菌属细菌的耐药机制以产碳青霉烯酶（KPC）为主，PFGE 分析的8株肺炎克雷伯菌可分成 A、B 两种PFGE 型，其中 A 型4株、B 型4株。结论产 KPC 是本院克雷伯菌属细菌耐碳青霉烯类抗菌药物的主要原因，应重视医院细菌耐药性监测及医院感染的监控。