摘要
目的研究耐碳青霉烯类肺炎克雷伯菌(CRKP)耐药表型检测的价值。方法对2018-2021年该院分离的450株肺炎克雷伯菌(KP)进行分析,统计分离情况,分析KP的耐碳青霉烯类表型,同时选取替加环素、美罗培南、亚胺培南等药物进行药敏试验;并对CRKP进行耐药表型分析,进而对比常见耐药表型的耐药及分布情况。结果450株KP对亚胺培南、美罗培南、厄他培南的耐药率分别为6.00%、6.00%、7.78%,其中CRKP共36株。同源性分析显示,36株CRKP中出现3种主要克隆型,有11株为ST11型,7株为ST2305型,5株为ST2390型,总体以≥15岁人群感染为主,住院时间较长,痰液标本培养获得居多,主要分布于ICU、肺病科、老年病科。其中ST11型、ST2305型、ST2390型3种优势菌株对替加环素的耐药率均低于20%,对磺胺类药物的耐药率均低于65%,但ST11型菌株对喹诺酮类药物的耐药率高于90%,ST2305型对氨基糖苷类药物的耐药率高于85%。结论耐药表型检测适合CRKP流行病学调查,结合常规药敏试验,能有效预防和控制CRKP的播散。
Objective To study the value of drug resistance phenotype detection of carbapenem-resistant Klebsiella pneumoniae(CRKP).Methods A total of 450 strains of Klebsiella pneumoniae(KP)isolated in Yunyang Hospital of Traditional Chinese Medicine in Chongqing from 2018 to 2021 were analyzed,the isolation status was counted,and the carbapenem resistant phenotype of KP was analyzed.At the same time,tegacyclin,meropenem,imipenem and other drugs were selected for drug sensitivity test.The drug resistance phenotypes of CRKP were analyzed,then the drug resistance and distribution of common drug resistance phenotypes were compared.Results The resistance rates of 450 strains of KP to imipenem,meropenem and ertapenem were 6.00%,6.00%and 7.78%respectively,including 36 strains of CRKP.Homology analysis showed that there were 3 main clonal types in 36 CRKP strains,including 11 stains of ST11,7 stains of ST2305,5 stains of ST2390.Generally,it was mainly isolated from people 15 or more than 15 years old,with a long hospital stay,and the majority of sputum culture was obtained,which was mainly distributed in ICU,department of pulmonary disease,department of geriatrics.Among them,the resistance rates of three dominant strains of ST11,ST2305 and ST2390 to tegacyclin were less than 20%.The resistance rates to sulfonamides were all lower than 65%,but the resistance rates to quinolones of ST11 strain were higher than 90%,and the resistance rates to aminoglycosides of ST2305 strain were higher than 85%.Conclusion The detection of drug resistance phenotype is suitable for the epidemiological investigation of CRKP.Combined with routine drug sensitivity test,it could effectively prevent and control the spread of CRKP.
作者
黄小华
施瑜
HUANG Xiaohua;SHI Yu(Department of Clinical Laboratory,Yunyang Hospital of Traditional Chinese Medicine in Chongqing,Chongqing 404500,China)
出处
《检验医学与临床》
CAS
2022年第14期1950-1954,共5页
Laboratory Medicine and Clinic
关键词
肺炎克雷伯菌
耐碳青霉烯类
耐药表型
多位点序列分型
耐药率
Klebsiella pneumoniae
carbapenems resistance
drug resistance phenotype
multi locus sequence typing
resistance rate
