重症监护室患者及物表中分离的碳青霉烯耐药肺炎克雷伯菌分子流行病学与耐药机制分析

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Abstract Objective To understand the drug resistance mechanism and molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from patients and object surface in the intensive care unit (ICU), and to adopt reasonable strategies to block its transmission in hospital based on the actual situation of this ward, so as to provide an important basis for clinical rational drug use and nosocomial infection control. Methods A total of 29 strains of CRKP isolated from ICU patients and object surface in Xindu District People’s Hospital of Chengdu (hereinafter referred to as “our Hospital”) from July 2019 to June 2020 were collected. The antimicrobial resistance of common clinical antibiotics was detected by MicroScan WalkAway40 bacterial susceptibility analyzer and paper diffusion method. Five common carbapenem-resistant genes were detected by polymerase chain reaction (PCR) amplification and DNA sequence analysis. The gene correlation among the strains was detected by multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE). Results A total of 29 strains of CRKP were sensitive to Tigecycline and Polymyxin, and had high sensitivity to Amikacin and Gentamicin, and high resistance to other common antibacterial drugs. PCR and DNA sequencing showed that among 29 strains of CRKP, only one strain was KPC-2 type. The other 28 strains were NDM-1 type. No other resistance genotypes were detected. MLST and PFGE detection results showed that 29 strains of CRKP were classified into six types, with ST12 type as the main type. A total of 22 strains of ST12 type CRKP, 11 strains of ST12/A type and six strains of ST12/B type were detected. The object surface strain was ST12/A type. Conclusion In ICU ward of our hospital, NDM-1 carbapenemase ST12/A type is the main type of CRKP, and the isolated strains on the object surface are consistent with the epidemic strains in this area, with high homology. Relevant departments should strengthen the intervention of nosocomial transmission of CRKP, clarify the transmission route, and take a series of prevention and control measures to prevent the spread of drug-resistant strains in the hospital.

Key words： Carbapenem-resistant Klebsiella pneumoniae Multilocus sequence typing Pulsed field gel electrophoresis Resistance mechanisms

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	CHEN Tao TANG Jiao DU Jingjing LIU Xiaohua CHEN Jing

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CHEN Tao TANG Jiao DU Jingjing LIU Xiaohua CHEN Jing. Molecular epidemiology and drug resistance mechanism analysis of carbapenem-resistant Klebsiella pneumoniae isolated from patients and object surface in the intensive care unit[J]. 中国医药导报, 2021, 18(28): 160-163,172.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I28/160

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