摘要
目的 探究重症医学科产碳青霉烯酶-2(Klebsiella Pneumoniae Carbapenemase,KPC-2)肺炎克雷伯菌的耐药状况并分析其同源性情况。方法 回顾性选取2020年10月—2022年9月睢宁县人民医院收治的46例重症医学科患者的临床资料,从中提取46株耐青霉烯类肺炎克雷伯菌菌株,进行药敏性试验、mCIM及eCIM联合试验,并采用聚合酶链反应(Polymerase Chain Reaction,PCR)扩增法检测待测菌的耐药基因,实施序列检测,使用脉冲场凝胶电泳(Pulsed field Gel Electrophoresis,PFGE)实施同源性分析。结果 待测菌对替加环素、复方新诺明、阿米卡星、妥布霉素及庆大霉素有敏感性;mCIM及eCIM试验结果显示46株耐青霉烯类肺炎克雷伯菌均产丝氨酸碳青霉烯酶;待测菌株携带肺炎克雷伯菌碳青霉烯酶基因阳性率达100.00%。结论 产丝氨酸碳青霉烯酶是造成ICU分离耐青霉烯类肺炎克雷伯菌的耐药机制,酶基因为KPC-2型,且本院重症医学科存在耐青霉烯类肺炎克雷伯的克隆传播。
Objective To investigate the drug resistance of Klebsiella pneumoniae carbapenemase(KPC-2) produced by Klebsiella pneumoniae in intensive care department and analyze its homology.Methods The clinical data of 46 patients admitted to the intensive care department of Suining County People's Hospital from October 2020 to September 2022 were retrospectively selected.46 strains of penamenem-resistant Klebsiella pneumoniae were extracted from the patients.Drug susceptibility test,mCIM and eCIM combined test were conducted.The drug resistance genes of the bacteria were detected by polymerase chain reaction(PCR) amplification,sequence detection was performed,and homology analysis was performed by pulsed field gel electrophoresis(PFGE).Results The tested bacteria were susceptible to tigecycline,cotrimoxazole,amikacin,tobramycin and gentamicin.mCIM and eCIM showed that all 46 strains of penicillin-resistant Klebsiella pneumoniae produced serine carbapenemases.The positive rate of Klebsiella pneumoniae carbapenemase gene was 100.00%.Conclusion Serine-producing carbapenemase is the resistance mechanism responsible for the isolation of penicillin-resistant Klebsiella pneumoniae in the ICU,the enzyme gene is of KPC-2 type,and there is a clonal transmission of penicillin-resistant Klebsiella pneumoniae in the Department of Critical Care Medicine of the hospital.
作者
戚丽敏
陈建军
QI Limin;CHEN Jianjun(Department of Laboratory,Suining County People's Hospital,Xuzhou,Jiangsu Province,221200 China;Department of Laboratory,Xuzhou First People's Hospital,Xuzhou,Jiangsu Province,221002 China)
出处
《系统医学》
2024年第4期48-51,共4页
Systems Medicine
关键词
重症医学科
肺炎克雷伯菌
同源性
耐药性
Critical care medicine unit
Klebsiella pneumoniae
Homology
Drug resistance
