發(fā)布時間：2018-05-06 09:27

  本文選題：肺炎克雷伯菌 + 耐藥基因　； 參考：《中華醫(yī)院感染學(xué)雜志》2016年12期

【摘要】：目的對耐亞胺培南肺炎克雷伯菌的耐藥基因攜帶情況及分子流行病學(xué)特征進(jìn)行研究,以降低耐藥率。方法對2013年10月-2014年5月臨床分離的15株耐亞胺培南肺炎克雷伯菌,采用Hodge試驗檢測碳青霉烯酶表型;采用PCR法檢測碳青霉烯酶、AmpC酶和ESBLs耐藥基因及整合子,進(jìn)行測序及網(wǎng)上比對確定基因型;采用腸桿菌科基因間重復(fù)序列(ERIC)和多位點(diǎn)序列分型(MLST)對菌株進(jìn)行同源性和遺傳相關(guān)性研究。結(jié)果 15株耐亞胺培南肺炎克雷伯菌均檢出KPC-2、TEM-1、SHV和CTX-M型基因,SHV12和CTX-M-24為主要基因亞型;未檢測到IMP、VIM、OXA和NDM碳青霉烯酶基因和AmpC酶基因;各帶有Ⅰ類整合子,整合的主要耐藥基因為aadA2;同源性和遺傳相關(guān)性分析,15株耐亞胺培南肺炎克雷伯菌可分為A、B、C 3種ERIC類別,12株A菌為ST11型,2株B菌為ST290和ST147,1株C菌為ST967;15株肺炎克雷伯菌呈多藥耐藥或泛耐藥,僅磺胺甲VA唑/甲氧芐啶的敏感率50.0%。結(jié)論 15株肺炎克雷伯菌的多藥耐藥或泛耐藥與菌株攜帶KPC-2碳青霉烯酶、CTX-M型ESBLs和其他β-內(nèi)酰胺酶及整合子有關(guān);產(chǎn)KPC-2肺炎克雷伯菌在神經(jīng)外科病區(qū)呈克隆傳播,ST11型菌株為此次流行的主要株;發(fā)現(xiàn)ST290和ST967型產(chǎn)KPC-2肺炎克雷伯菌。
[Abstract]:Objective to study the gene carrying and molecular epidemiology of imipenem-resistant Klebsiella pneumoniae in order to reduce the drug resistance rate. Methods Fifteen strains of Klebsiella pneumoniae resistant to imipenem were isolated from October 2013 to May 2014. The phenotype of carbapenem was detected by Hodge test, and the genes and integrons of carbapenem enzyme AMPC and ESBLs resistant genes were detected by PCR assay. The genotypes were determined by sequencing and net alignment, and the homology and genetic correlation of the strains were studied by means of ERICI and MLSTs. Results all 15 strains of Klebsiella pneumoniae resistant to imipenem pneumoniae were found to be the main subtypes of KPC-2TEM-1SHV and CTX-M type genes, and no Imphodopsin OXA and NDM carbapenase genes and AmpC genes were detected, each with class 鈪，

本文編號：1851778