[1]蒋子豪,赵永新,苏　兵,等.耐碳青霉烯类克雷伯菌耐药性分析[J].新乡医学院学报,2020,37(11):1057-1061.[doi:10.7683/xxyxyxb.2020.11.012]
　JIANG Zihao,ZHAO Yongxin,SU Bing,et al.Drug resistance analysis of carbapenem resistant Klebsiella bacteria[J].Journal of Xinxiang Medical University,2020,37(11):1057-1061.[doi:10.7683/xxyxyxb.2020.11.012]
点击复制

耐碳青霉烯类克雷伯菌耐药性分析
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年11
页码:
1057-1061
栏目:
临床研究
出版日期:
2020-11-05

文章信息/Info

Title:
Drug resistance analysis of carbapenem resistant Klebsiella bacteria
作者:
蒋子豪1; 赵永新1; 苏　兵1; 庞敬莹2; 王妍妍1; 朱　辉1; 张铁汉1
（1.新乡医学院第三附属医院检验科，河南　 新乡　453003；2.新乡医学院三全学院临床医学院，河南　新乡　453003）
Author(s):
JIANG Zihao1; ZHAO Yongxin1; SU Bing1; PANG Jingying2; WANG Yanyan1; ZHU Hui1; ZHANG Tiehan1
(1.Department of Laboratory,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;2.Department of Clinical Medicine，the Sanquan College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
克雷伯菌属; 耐药性; 同源性分析
Keywords:
Klebsiella; antibiotic resistance; homology analysis
分类号:
R446.5
DOI:
10.7683/xxyxyxb.2020.11.012
文献标志码:
A
摘要:
目的　研究耐碳青霉烯类克雷伯菌属细菌（CR-Klebsiella）的耐药性和基因型特点，为临床合理用药提供依据。方法　收集新乡医学院第三附属医院2016年1月至2019年6月临床分离的CR-Klebsiella 112株，统计其耐药情况。采用改良碳青霉烯酶灭活试验检测菌株耐药表型，聚合酶链式反应检测常见碳青霉烯类耐药基因（KPC、NDM、IMP），多位点序列分型方法分析耐碳青霉烯类肺炎克雷伯菌（CR-KP）菌株间同源性。结果　112株CR-Klebsiella中以CR-KP为主（80.36%，90/112），其次为臭鼻克雷伯菌（15.18%，17/112）和产酸克雷伯菌占（4.46%，5/112）。3种CR-Klebsiella对多数β-内酰胺类抗菌药物耐药或者敏感性降低。112株菌株中共有66株产丝氨酸碳青霉烯酶，10株产金属碳青霉烯酶。76株产酶菌株中有73株检测到KPC基因，3株检测到NDM基因，未检测到IMP基因。41株CR-KP克隆分型以ST11型为主，其次是ST15型。结论　CR-Klebsiella对常见抗菌药物耐药严重，多数菌株携带相关耐药基因。
Abstract:
Objective　To investigate the antibiotic resistance characteristics and genotypes of carbapenem resistant Klebsiella bacteria (CR-klebsiella),so as to provide basis for clinical rational drug use.Methods　One hundred and twelve CR-Klebsiella strains which were separated in the Third Affiliated Hospital of Xinxiang Medical University from January 2016 to June 2019 were collected,and their antibiotic resistance characteristics were analyzed.The resistant phenotypes of CR-Klebsiella strains were detected by modified carbapenem inactivation method;the common carbapenem resistant gene (KPC,NDM,IMP) was detected by polymerase chain reaction;the homology of carbapenem resistant Klebsiella pneumoniae(CR-KP) strains was analyzed by multilocus sequence typing.Results　Among the 112 CR-Klebsiella strains,CR-KP was dominant (80.36%,90/112),followed by Klebsiella odorifera(15.18%,17/112)and Klebsiella acidogenes（4.46%，5/112).Three kinds of CR-Klebsiella were resistant or less sensitive to most of the antibiotics.Among the 112 CR-Klebsiella strains,66 strains were serine carbapenem and 10 strains were metal carbapenem.In 76 enzyme producing strains,KPC gene was detected in 73 strains,NDM gene was detected in 3 strains,but IMP was not detected.The clonal typing of 41 CR-KP strains were mainly ST11,followed by ST15.Conclusion　CR-Klebsiella has serious resistance to common antibiotics,a large proportion of the strains carry relevant resistance genes.

参考文献/References:

［1］　赵永新,李素敏,张卫群,等.产生ESBLs和AmpC酶的肠杆菌科细菌检测及耐药性分析［J］.中国抗生素杂志,2012,37(3):240-243.
［2］　VANDUIN D.Carbapenem-resistant enterobacteriaceae:what we know and what we need to know［J］.Virulence,2017,8(4):379-382.
［3］　吕继芳,郑焙文,张静,等.耐碳青霉烯类肺炎克雷伯菌分子流行病学和耐药基因分析［J］.中国抗生素杂志,2016,41(5):356-361.
［4］　张露方,耿荣华,曲芬.耐碳青霉烯肠杆菌科细菌的流行病学特点以及抗生素应用策略［J］.中国抗生素杂志,2019,44(9):1008-1014.
［5］　MARKOVSKA R,STOEVA T,SCHNEIDER I,et al.Clonal dissemination of multilocus sequence type ST15 KPC-2-producing Klebsiella pneumoniae in Bulgaria［J］.Apmis,2015,123(10):887-894.
［6］　MUNOZ-PRICE L S,POIREL L,BONOMO R A,et al.Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases［J］.Lancet Infect Dis,2013,13(9):785-796.
［7］　Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing:27th informational supplement，CLSI,M100-S27［S］.Wayne PA:CLSI,2017.
［8］　GUTIERREZ-GUTIERREZ B,SALAMANCA E,DECUETO M,et al.Effect of appropriate combination therapy on mortality of patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae (INCREMENT):a retrospective cohort study［J］.Lancet Infect Dis,2017,17(7):726-734.
［9］　徐安,卓超,苏丹虹,等.2005—2014年CHINET克雷伯菌属细菌耐药性监测［J］.中国感染与化疗杂志,2016,16(3):267-274.
［10］　王晶,陈良安.克雷白菌属相关感染疾病及其耐药机制研究进展［J］.慢性病学杂志,2014,15(4):270-273.
［11］　DONG F,ZHANG Y,YAO K,et al.Epidemiology of carbapenem-resistant Klebsiella pneumoniae bloodstream infections in a chinese children′s hospital:predominance of new delhi metallo-β-lactamase-1［J］.Microb Drug Resist,2018,24(2):154-160.
［12］　孙吉,何鸽飞,沈晖,等.耐碳青霉烯类肺炎克雷伯菌的药敏结果及耐药基因［J］.中国感染控制杂志,2019,18(6):489-494.
［13］　ZHANG Y,WANG Q,YIN Y,et al.Epidemiology of carbapenem-resistant enterobacteriaceae infections:report from the China CRE network［J］.Antimicrob Agents Ch,2018,62(2):1-33.
［14］　WANG Q,WANG X,WANG J,et al.Phenotypic and genotypic characterization of carbapenem-resistant enterobacteriaceae:data from a longitudinal large-scale CRE study in China (2012-2016)［J］.Clin Infect Dis,2018,67(2):196-205.
［15］　BULIK C C,NICOLAU D P.Double-carbapenem therapy for carbapenemase-producing Klebsiella pneumoniae［J］.Antimicrob Agents Ch,2017,55(6):3002-3004.
［16］　王妍妍,赵永新,王伟,等.2006年—2010年医院感染细菌耐药性监测结果分析［J］.中国卫生检验杂志,2014,24(19):2875-2878.
［17］　VANDER K,DEHAAN A,PLUISTER G N,et al.The carbapenem inactivation method (CIM),a simple and low-cost alternative for the carba NP test to assess phenotypic carbapenemase activity in gram-negative rods［J］.PLoS One,2015,10(3):801-813.
［18］　李进,黎敏,刘雯瑜,等.耐碳青霉烯类肠杆菌科细菌的耐药特征及基因分型［J］.中华医院感染学杂志,2018,28(24):3681-3684.
［19］　张志军,鹿麟,牛法霞,等.耐碳青霉烯类肺炎克雷伯菌的耐药机制与分子流行病学特征［J］.中国感染控制杂志,2018,17(9):759-763.
［20］　LASCOLS C,PEIRANO G,HACKEL M,et al.Surveillance and molecular epidemiology of Klebsiella pneumoniae isolates that produce carbapenemases:first report of OXA-48-like enzymes in North America［J］.Antimicrob Agents Ch,2012,57(1):130-136.
［21］　VANDUIN D,DOI Y.The global epidemiology of carbapenemase-producing Enterobacteriaceae［J］.Virulence,2017,8(4):460-469.
［22］　苏乐斌,李柏生,谭海芳,等.广东省肇庆市肺炎克雷伯菌临床分离株的耐药性与MLST分型研究［J］.中国抗生素杂志,2019,44(2):260-265.
［23］　陈妍妍,宋巍,曹阳,等.碳青霉烯耐药克雷伯菌耐药机制研究［J］.天津医科大学学报,2017,23(6):537-541.

相似文献/References:

[1]赵丽娟,汤丽霞,黄干荣,等.不同标本大肠埃希茵214株耐药性调查[J].新乡医学院学报,2002,19(04):271.
[2]褚月娇,韩莹莹,黄婷婷,等.老年与中青年患者产超广谱β-内酰胺酶肺炎克雷伯菌的分布及耐药性对比分析[J].新乡医学院学报,2017,34(9):803.[doi:10.7683/xxyxyxb.2017.09.006]
　CHU Yue-jiao,HAN Ying-ying,HUANG Ting-ting,et al.Comparative analysis of distribution and drug resistance of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in elderly and young and middle-aged patients[J].Journal of Xinxiang Medical University,2017,34(11):803.[doi:10.7683/xxyxyxb.2017.09.006]
[3]王　娟,李　凯,王勇兵,等.革兰阴性菌血流感染患儿临床特点及病原菌分布和耐药性分析[J].新乡医学院学报,2019,36(7):634.[doi:10.7683/xxyxyxb.2019.07.008]
　WANG Juan,LI Kai,WANG Yong-bing,et al.Clinical characteristics,pathogenic bacteria distribution and drug resistance of children with gram-negative bacterial bloodstream infection[J].Journal of Xinxiang Medical University,2019,36(11):634.[doi:10.7683/xxyxyxb.2019.07.008]
[4]郭雄飞,王　挺,汤立新.脊柱手术后切口感染患者病原菌分布及耐药性和血清炎性因子水平分析[J].新乡医学院学报,2019,36(10):963.[doi:10.7683/xxyxyxb.2019.10.014]
　GUO Xiong-fei,WANG Ting,TANG Li-xin.Distribution of pathogenic bacteria and analysis of drug resistance and the levels of serum inflammatory factors in patients with incision infection after spinal operation[J].Journal of Xinxiang Medical University,2019,36(11):963.[doi:10.7683/xxyxyxb.2019.10.014]
[5]闫登科,陶　丽,郝　洁,等.内质网应激对肝癌细胞硼替佐米耐药性的影响[J].新乡医学院学报,2021,38(2):106.[doi:10.7683/xxyxyxb.2021.02.002]
　YAN Dengke,TAO Li,HAO Jie,et al.Effect of endoplasmic reticulum stress on the resistance of hepatocellular carcinoma cells to bortezomib[J].Journal of Xinxiang Medical University,2021,38(11):106.[doi:10.7683/xxyxyxb.2021.02.002]
[6]秦　 超,冯永海,杨闪闪,等.结肠癌转移相关基因1表达与肺鳞状细胞癌和肺腺癌细胞顺铂耐药性的相关性[J].新乡医学院学报,2021,38(3):249.[doi:10.7683/xxyxyxb.2021.03.009]
　QIN Chao,FENG Yonghai,YANG Shanshan,et al.Relationship between the expression of metastasis-associated in colon cancer 1 and cisplatin resistance in pulmonary squamous cell carcinoma and pulmonary adenocarcinoma cells[J].Journal of Xinxiang Medical University,2021,38(11):249.[doi:10.7683/xxyxyxb.2021.03.009]
[7]邹　鹏,涂继军,陈治权,等.骨科患者创面感染肺炎克雷伯菌耐药性及毒力特性研究[J].新乡医学院学报,2021,38(6):534.[doi:10.7683/xxyxyxb.2021.06.008]
　ZOU Peng,TU Jijun,CHEN Zhiquan,et al.Resistance and virulence characteristics of Klebsiella pneumoniae isolated from patients with wounds infection in department of orthopedics[J].Journal of Xinxiang Medical University,2021,38(11):534.[doi:10.7683/xxyxyxb.2021.06.008]
[8]曹　彤,阳艳丽.急性淋巴细胞白血病患儿院内感染的病原菌分布及耐药性分析[J].新乡医学院学报,2020,37(2):173.[doi:10.7683/xxyxyxb.2020.02.017]
　CAO Tong,YANG Yanli.Distribution and drug resistance of pathogenic bacteria of nosocomial infection in children with acute lymphoblastic leukemia[J].Journal of Xinxiang Medical University,2020,37(11):173.[doi:10.7683/xxyxyxb.2020.02.017]
[9]韩　冬,张　超,杜守峰,等.冠状动脉旁路移植术后感染病原菌分布、耐药性及危险因素分析[J].新乡医学院学报,2020,37(8):773.[doi:10.7683/xxyxyxb.2020.08.017]
　HAN Dong,ZHANG Chao,DU Shoufeng,et al.Distribution characteristics and drug resistance of pathogenic bacteria and the risk factors of postoperative infection in patients underwent coronary artery bypass grafting[J].Journal of Xinxiang Medical University,2020,37(11):773.[doi:10.7683/xxyxyxb.2020.08.017]
[10]邢彦峰,巨超龙.结直肠癌患者术后感染的危险因素及病原菌和耐药性分析[J].新乡医学院学报,2018,35(2):110.[doi:10.7683/xxyxyxb.2018.02.007]
　XING Yan-feng,JU Chao-long.Analysis of the risk factors，pathogenic bacteria and drug resistance of postoperative infection in patients with colorectal cancer[J].Journal of Xinxiang Medical University,2018,35(11):110.[doi:10.7683/xxyxyxb.2018.02.007]

更新日期/Last Update: 2020-11-05