中华实验和临床感染病杂志（电子版）
中華實驗和臨床感染病雜誌（電子版）
중화실험화림상감염병잡지（전자판）
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2013年
4期
541-545
,共5页
耿荣华%王晓杰%高华英%张锦前%成军
耿榮華%王曉傑%高華英%張錦前%成軍
경영화%왕효걸%고화영%장금전%성군
肺炎克雷伯菌%β-内酰胺酶%碳青霉烯酶%耐药基因
肺炎剋雷伯菌%β-內酰胺酶%碳青黴烯酶%耐藥基因
폐염극뢰백균%β-내선알매%탄청매희매%내약기인
Klebsiella pneumoniae%β-lactamase%Carbapenem%Resistance gene
目的：探讨肺炎克雷伯菌（Kpn）耐碳青霉烯类药物的耐药基因型。方法收集2011年1月至12月本院分离到的肺炎克雷伯菌，用K-B法进行药敏实验，筛选出6株耐碳青霉烯类抗菌药物的肺炎克雷伯菌（CRKP），采用改良Hodge试验检测菌株产碳青霉烯酶，用乙二胺四乙酸（EDTA）纸片法检测金属酶表型，聚合酶链式反应（PCR）鉴定肺炎克雷伯菌耐碳青霉烯酶（KPC）基因及其他β-内酰胺酶基因。结果6株CRKP对头孢噻肟、头孢他啶、头孢呋辛、阿莫西林/克拉维酸、氨苄西林、氨苄西林/舒巴坦、庆大霉素、复方新诺明、哌拉西林/三唑巴坦、头孢哌酮/舒巴坦、头孢吡肟、氨曲南、美罗培南、亚胺培南均耐药，对多黏菌素、米诺环素、磷霉素、阿米卡星等敏感，改良Hodge试验提示6株CRKP均产碳青霉烯酶，EDTA纸片法检测显示不产金属酶；PCR鉴定出该6株CRKP均携带blaKPC-2型基因，部分菌株携带blaSHV及blaTEM型广谱β-内酰胺酶耐药基因。结论 BlaKPC-2耐药基因为Kpn对碳青霉烯类药物耐药的主要原因。
目的：探討肺炎剋雷伯菌（Kpn）耐碳青黴烯類藥物的耐藥基因型。方法收集2011年1月至12月本院分離到的肺炎剋雷伯菌，用K-B法進行藥敏實驗，篩選齣6株耐碳青黴烯類抗菌藥物的肺炎剋雷伯菌（CRKP），採用改良Hodge試驗檢測菌株產碳青黴烯酶，用乙二胺四乙痠（EDTA）紙片法檢測金屬酶錶型，聚閤酶鏈式反應（PCR）鑒定肺炎剋雷伯菌耐碳青黴烯酶（KPC）基因及其他β-內酰胺酶基因。結果6株CRKP對頭孢噻肟、頭孢他啶、頭孢呋辛、阿莫西林/剋拉維痠、氨芐西林、氨芐西林/舒巴坦、慶大黴素、複方新諾明、哌拉西林/三唑巴坦、頭孢哌酮/舒巴坦、頭孢吡肟、氨麯南、美囉培南、亞胺培南均耐藥，對多黏菌素、米諾環素、燐黴素、阿米卡星等敏感，改良Hodge試驗提示6株CRKP均產碳青黴烯酶，EDTA紙片法檢測顯示不產金屬酶；PCR鑒定齣該6株CRKP均攜帶blaKPC-2型基因，部分菌株攜帶blaSHV及blaTEM型廣譜β-內酰胺酶耐藥基因。結論 BlaKPC-2耐藥基因為Kpn對碳青黴烯類藥物耐藥的主要原因。
목적：탐토폐염극뢰백균（Kpn）내탄청매희류약물적내약기인형。방법수집2011년1월지12월본원분리도적폐염극뢰백균，용K-B법진행약민실험，사선출6주내탄청매희류항균약물적폐염극뢰백균（CRKP），채용개량Hodge시험검측균주산탄청매희매，용을이알사을산（EDTA）지편법검측금속매표형，취합매련식반응（PCR）감정폐염극뢰백균내탄청매희매（KPC）기인급기타β-내선알매기인。결과6주CRKP대두포새우、두포타정、두포부신、아막서림/극랍유산、안변서림、안변서림/서파탄、경대매소、복방신낙명、고랍서림/삼서파탄、두포고동/서파탄、두포필우、안곡남、미라배남、아알배남균내약，대다점균소、미낙배소、린매소、아미잡성등민감，개량Hodge시험제시6주CRKP균산탄청매희매，EDTA지편법검측현시불산금속매；PCR감정출해6주CRKP균휴대blaKPC-2형기인，부분균주휴대blaSHV급blaTEM형엄보β-내선알매내약기인。결론 BlaKPC-2내약기인위Kpn대탄청매희류약물내약적주요원인。
Objective To understand the drug resistance genotype of Klebsiella pneumoniae (Kpn) resistant to carbapenems. Methods Klebsiella pneumoniae isolated in our hospital from January to December, 2011 were collected, K-B was used for drug susceptibility test, 6 Klebsiella pneumoniae strains were screened to be resistant to carbapenems. Modified Hodge test was used for the detection of strains producing carbapenemases, ethylene diamine tetraacetic acid (EDTA) disk diffusion method was used for detection of metal enzyme phenotypes, KPC gene and other beta lactamases genes were identiifed by using PCR. Results There were 6 Klebsiella pneumoniae strains resistant to carbapenems drug, they were resistant to cefotaxime, ceftazidine, cefuroxime, amoxicillin, clavulanate, ampicillin, ampicillin, subactam, gentamycin, SMZ/TMP, piperacillin/tazobactam, cefperazone-sulbactam, cefepime, aztreonam, meropenem and imipenem, but sensitive to polymyxin, minocycline, fosfomycin, amikacin. All 6 strains produced carbapenemases but couldn’t produce metal enzyme;all of the 6 strains carried blaKPC-2, part of them carried blaSHV and blaTEM. Conclusions The blaKPC-2 is the main reason for the resistanceof Kpn to carbapenem.
