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目的肺炎克雷伯菌是一类重要的引起院内感染的病原微生物,可导致机体多个器官和组织受累。本研究主要是针对携带有碳青霉烯酶基因的肺炎克雷伯菌进行分子特征和流行状况的评价。方法本研究中所用菌株是2008-2012年分离自山西省长治某医院的标本,通过琼脂扩散和E纸条试验来分析菌株的药敏状况。碳青霉烯酶的产生情况经Carba NP试验来确认,而碳青霉烯酶基因的测定及确证由PCR和DNA测序完成。最后,将碳青霉烯类抗生素耐药菌株进行脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)研究。结果 1 297株临床分离的肺炎克雷伯菌中,有9株对碳青霉烯类抗生素的耐药株,它们都是产A组碳青霉烯酶、肺炎克雷伯菌的碳青霉烯酶(KPC-2)基因阳性,而其它的检测基因均为阴性。尽管9株菌都属于MLST中的ST11型,但就PFGE分析发现,可能存在两次院内感染的传播:分别在2010和2012年。结论携带KPC-2基因的耐药肺炎克雷伯菌已经在医院内传播,加强院内严密监控和制定严格的感染控制措施已是刻不容缓。
Objective Klebsiella pneumoniae is an important class of pathogenic microorganisms that cause nosocomial infections that can cause multiple organ and tissue involvement in the body. In this study, molecular characteristics and prevalence of Klebsiella pneumoniae carrying carbapenemase genes were evaluated. Methods The strains used in this study were isolated from Changzhi Hospital of Shanxi Province from 2008 to 2012. The susceptibility of the strains was analyzed by agar diffusion and E-strip test. The carbapenemase production was confirmed by the Carba NP assay, while the determination and confirmation of the carbapenemase gene was accomplished by PCR and DNA sequencing. Finally, the carbapenem-resistant strains were subjected to pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results Among 1297 clinically isolated Klebsiella pneumoniae strains, 9 were resistant to carbapenem-resistant strains, all of which were carbapenemase producing group A, carbapenema of Klebsiella pneumoniae, Enzyme (KPC-2) gene positive, while the other test gene were negative. Although all nine strains belonged to ST11 in MLST, PFGE analysis found that there could be two nosocomial infections transmitted in 2010 and 2012, respectively. Conclusion Klebsiella pneumoniae resistant to KPC-2 gene have been transmitted in hospitals. It is imperative to strengthen the close surveillance and strict infection control measures in the hospital.