本文選題：肺炎克雷伯菌 + 碳青霉烯酶��； 參考：《中國(guó)實(shí)驗(yàn)診斷學(xué)》2017年02期

【摘要】：目的通過(guò)對(duì)碳青霉烯類耐藥肺炎克雷伯菌(CRKP)的檢測(cè)及病例分析,了解CRKP對(duì)碳青霉烯類抗菌藥物的耐藥機(jī)制及感染現(xiàn)狀,為臨床抗感染治療及院感控制提供依據(jù)。方法應(yīng)用BD phoenixTM-100全自動(dòng)細(xì)菌鑒定及藥敏分析系統(tǒng)篩選耐亞胺培南或美羅培南的肺炎克雷伯菌,然后通過(guò)改良Hodge試驗(yàn)檢測(cè)碳青霉烯酶表型,用PCR方法檢測(cè)KPC、NDM-1和OXA-48碳青霉烯酶耐藥基因。結(jié)果 71株CRKP改良Hodge試驗(yàn)陽(yáng)性56株,陽(yáng)性率為78.9%,PCR結(jié)果顯示:71株CRKP中有53株檢測(cè)出blaKPC-2基因、8株blaNDM-1基因、2株blaOXA-48基因;標(biāo)本來(lái)源主要見于ICU、腎內(nèi)科和神經(jīng)內(nèi)科等病房的痰液、尿液和引流液標(biāo)本;藥敏結(jié)果顯示:所分離的71株CRKP除了對(duì)阿米卡星、替加環(huán)素和多粘菌素的耐藥率較低外,對(duì)其他抗菌藥物的耐藥率均70%。結(jié)論 CRKP臨床分布較為廣泛,多藥耐藥嚴(yán)重,其耐藥基因以產(chǎn)KPC-2型為主,但同時(shí)還出現(xiàn)了NDM-1和OXA-48基因型,應(yīng)加強(qiáng)監(jiān)控。
[Abstract]:Objective to investigate the mechanism of CRKP resistance to carbapenem antibiotics and the current situation of infection through detection and case analysis of carbapenem resistant Klebsiella pneumoniae, and to provide evidence for clinical anti-infective treatment and hospital control. Methods Klebsiella pneumoniae resistant to imipenem or meropenem were screened by BD phoenixTM-100 automatic bacteria identification and drug sensitivity analysis system, and carbapenem phenotypes were detected by modified Hodge test. KPC-NDM-1 and OXA-48 carbapenem resistance genes were detected by PCR. Results there were 56 positive strains of CRKP modified Hodge test, and the positive rate was 78.9%. The results showed that 53 of the 71 strains of CRKP had blaKPC-2 gene and 8 strains of blaNDM-1 gene and 2 strains of blaOXA-48 gene, the samples were mainly found in sputum of ICU, Department of Nephrology and Neurology, etc. The drug sensitivity of 71 strains of CRKP, except for amikacin, tegacyclin and polymyxin, was low, and the drug resistance rates to other antimicrobial agents were all 70%. Conclusion the clinical distribution of CRKP is widespread and the multidrug resistance is serious. The main gene of CRKP is KPC-2, but there are NDM-1 and OXA-48 genotypes, so the monitoring should be strengthened.
【作者單位】： 海軍青島第二療養(yǎng)院感控科;青島大學(xué)附屬青島市立醫(yī)院檢驗(yàn)科;青島大學(xué)附屬醫(yī)院檢驗(yàn)科;
【分類號(hào)】：R440

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相關(guān)期刊論文 前7條

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