[1]黄丽萍,肖力英,陈东杰,等.福州地区耐碳青霉烯肺炎克雷伯菌对头孢他啶-阿维巴坦的药敏情况及耐药分析[J].福建医药杂志,2021,43(05):5-9.
 HUANG Liping,XIAO Liying,CHEN Dongjie,et al.Analysis of drug sensitivity and resistance of carbapenem-resistant Klebsiella Pneumoniae to ceftazidime-avibactamin Fuzhou[J].FUJIAN MEDICAL JOURNAL,2021,43(05):5-9.
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福州地区耐碳青霉烯肺炎克雷伯菌对头孢他啶-阿维巴坦的药敏情况及耐药分析()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期数:
2021年05期
页码:
5-9
栏目:
临床研究
出版日期:
2021-10-15

文章信息/Info

Title:
Analysis of drug sensitivity and resistance of carbapenem-resistant Klebsiella Pneumoniae to ceftazidime-avibactamin Fuzhou
文章编号:
1002-2600(2021)05-0005-05
作者:
黄丽萍肖力英陈东杰1李鸿茹陈愉生2
福建医科大学省立临床医学院 福建省立医院呼吸与危重症医学科(福州 350001)
Author(s):
HUANG LipingXIAO LiyingCHEN DongjieLI HongruCHEN Yusheng
Department of Respiratory and Critical Care Medicine,Fujian Provicial Hospital,Provincial Clinical Medical College of Fujian Medical University,Fuzhou,Fujian 350001,China
关键词:
肺炎克雷伯菌 耐碳青霉烯 头孢他啶-阿维巴坦 耐药基因 多位点序列分型
Keywords:
Klebsiella pneumoniae Carbapenem resistant Ceftazidime-avibactam drug resistance gene multilocus sequence typing
分类号:
R91
文献标志码:
B
摘要:
目的 分析我院耐碳青霉烯肺炎克雷伯菌(CRKP)对头孢他啶-阿维巴坦(CZA)的药敏情况,探讨我院耐CZA的CRKP优势克隆株及携带耐药基因情况。方法 收集2017年7月至2019年6月本院耐碳青霉烯肺炎克雷伯菌121株,应用微量肉汤稀释法检测CZA的药敏情况,筛选出耐CZA的CRKP菌株。利用实时荧光多聚核苷酸链式反应(RT-PCR)及琼脂糖凝胶电泳对耐药基因(NDM、VIM、IMP、GIM、SPM、TMB、SMB、SIM、AIM、DIM)进行检测,将扩增产物进行双向测序和比对,确定其基因型,通过多位点序列分型(MLST)分析细菌同源性。结果 121株CRKP中有23株对CZA耐药,耐药率占19.01%。23株CZA耐药的CRKP中1株耐替加环素,14株对替加环素敏感,敏感率为60.87%,8株对替加环素中介(占34.78%)。23株CZA耐药的CRKP 菌株MLST分型结果:ST11型13株(56.52%),ST147型3株(13.04%),ST859型2株(8.70%),ST2123型、ST273型、ST3520型、ST3449型、ST15型各1株。23株CZA耐药的CRKP中有11株检出耐药基因NDM-1(47.83%),有4株检出耐药基因NDM-5(17.39%),其余8株均未检测到耐药基因。结论 ST11型是我院CZA耐药CRKP的主要菌株类型,与当前国内主要流行序列型相同,携带NDM-1、NDM-5基因可能与CRKP耐CZA有关,替加环素(TGC)可作为治疗CZA耐药CRKP的可选药物。
Abstract:
Objective To understand the drug sensitivity of carbapenem-resistant Klebsiella pneumoniae(CRKP)to ceftazidime-avibactam(CZA)in our hospital,and to analyze the dominant strains and the resistance genes of CRKP resistant to CZA.Methods A total of 121 strains of CRKP isolated and cultured in our hospital from July 2017 to June 2019 were collected.The minimal inhibitory concentration(MIC)of CZA was determined by micro broth dilution method,and the strains of CRKP resistant to CZA were screened out.We used the real-time fluorescence polymerase chain reaction(real-time fluorescence PCR)and agarose gel electrophoresis to detect drug-resistant genes(NDM,VIM,IMP,GIM,SPM,TMB,SMB,SIM,AIM,DIM).The amplified products were sequenced in both directions,and the sequencing results were compared to determine their genotypes,which were analyzed for bacterial homology by Multilocus sequence typing(MLST).Results Among the 121 strains of CRKP,23 were resistant to CZA,with drug resistance rate accounting for 19.01%.Among the 23 strains of CZA-resistant CRKP,1 strain was TGC-resistant(4.35%),14 were TGC-sensitive(60.87%),and 8 were TGC-intermediary(34.78%).MLST genotyping results of 23 strains of CZA-resistant CRKP were as follows:13 strains(56.52%)of ST11,3 strains(13.04%)of ST147,2 strains(8.70%)of ST859,1 strain in each of ST2123,ST273,ST3520,ST3449 and ST15.11 strains(47.83%)and 4 strains(17.39%)of the 23 CZA-resistant CRKP strains were found to have NDM-1 and NDM-5 genes,while the remaining 8 strains were not found to have any of resistant genes.Conclusion Type ST11 is the main strain type of CZA-resistant CRKP in our hospital,which is the same as the main epidemic sequence type in our country.Carrying NDM-1 and NDM-5 genes may be related to the resistance of CRKP to CZA.TGC can be used as an alternative drug for the treatment of CZA resistant CRKP.

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备注/Memo

备注/Memo:
基金项目:福建省卫健委青年科研课题(2017-2-14); 福建医科大学启航基金项目(2016QH119)
1 福建省立医院检验科; 2 通信作者
更新日期/Last Update: 2021-10-15