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目的研究本院感染性肺炎克雷伯菌碳青霉烯酶基因分布与耐药相关性。方法回顾性分析本院肺炎克雷伯菌耐药现状,收集26株耐碳青霉烯类肺炎克雷伯菌,依次进行ESBLs检测、改良Hodge实验、金属β-内酰胺酶检测(EDTA协同试验),三维试验检测Amp C酶;应用PCR技术进行碳青霉烯酶相关耐药基因检测,应用多位点序列分析(MLST)与e BURST分析,对肺炎克雷伯菌耐药菌进行分型与进化关系分析。结果本院耐碳青霉烯类耐药率逐年上升,2014年达8.2%。13株(50.0%)产碳青霉烯酶,8株(30.7%)产Amp C酶,2株(7.7%)产金属β-内酰胺酶;26株实验菌中PCR扩增结果示:KPC 12株,SHV 12株,TEM 5株,CTX 2株;未检出B类、C类、D类β-内酰胺酶基因;26株实验菌分为10个ST型,以ST11、ST15和ST764为主(各5株)。结论本院肺炎克雷伯菌耐药及多重耐药性严重,以KPC-2为主,本地区多重耐药肺炎克雷伯菌具有基因多态性,主要克隆系为ST11、ST15、ST764。
Objective To study the correlation between the carbapenemase gene distribution and drug resistance of Klebsiella pneumoniae in our hospital. Methods The clinical status of Klebsiella pneumoniae in our hospital was analyzed retrospectively. Twenty-six strains of Klebsiella pneumoniae were collected and tested for ESBLs, Hodge test, metal beta-lactamase test (EDTA synergistic test ), Three-dimensional test for detection of Amp C enzyme; PCR-based detection of carbapenemase-resistant genes, multi-locus sequence analysis (MLST) and e BURST analysis, Klebsiella pneumoniae resistant strains were typed And evolutionary relationship analysis. Results The rate of resistance to carbapenem in our hospital increased year by year, reaching 8.2% in 2014. 13 strains (50.0%) produced carbapenemase, 8 strains (30.7%) produced Amp C enzyme and 2 strains (7.7%) produced β-lactamases. The PCR amplification results of 26 strains 12 strains, 12 strains of SHV, 5 strains of TEM and 2 strains of CTX. No class B, C and D β-lactamase genes were detected. The 26 strains of experimental bacteria were divided into 10 ST genotypes, and ST11, ST15 and ST764 Mainly (5 each). Conclusions In our hospital, Klebsiella pneumoniae is multidrug-resistant and multi-drug resistant. KPC-2 is the mainstay. Klebsiella pneumoniae with multiple drug-resistant strains in our region has genetic polymorphisms. The main clones are ST11, ST15 and ST764.