2009~2011年耐碳青霉烯肺炎克雷伯杆菌的流行及整合子分析
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国家自然科学基金项目(81000754);江苏省研究生培养创新工程项目(2011-719)


Analysis of the prevalence and integrons distribution of carbapenem-resistant Klebsiella pneumonia (CRKP) in 2009-2010
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    目的:分析2009~2011年南京医科大学第一附属医院分离的耐碳青霉烯类肺炎克雷伯杆菌(CRKP)的流行状况及其携带的整合子的特征-基因盒的种类。方法:细菌鉴定用VITEK2compact全自动鉴定系统或API细菌鉴定系统;细菌药敏试验采用纸片扩散法(K-B法);根据CLSI2012 M100-S22判读结果;聚合酶链反应(PCR)检测Ⅰ-Ⅱ和Ⅲ类整合酶基因及Ⅰ类整合子可变区基因盒。结果:2009~2011年本院耐碳青霉烯类肺炎克雷伯杆菌的分离率显著增高,从1.6%增至11.2%;分离的菌株中对β-内酰胺类药物耐药率均高于95.0%;整合子阳性率为92.6%,均为Ⅰ类整合子,整合子可变区阳性率为78.7%,检测到的基因盒以aadA2最为常见,其次为aacA4-catB8-aadA1 及aadA2 + dfrA25。结论:本院CRKP的分离率增长迅速,Ⅰ类整合子在CRKP中普遍存在,有较强的从外周捕获耐药基因的能力;建议采取有效措施控制CRKP的传播。

    Abstract:

    Objective:To analyze the prevalence and integrons distribution of carbapenem-resistant Klebsiella pneumonia (CRKP) which isolated at the affiliated hospital of Nanjing Medical University from 2009 to 2010. Methods:All the isolates were identified by VITEK2 compact or API identification system. The antibiotic susceptibility of 81 CRKP was detected by K-B method. ClassⅠ,Ⅱ and Ⅲ integrons and their variable regions were detected by PCR. Results:The isolating rate of CRKP increased rapidly from 1.6% in 2009 to 11.2% in 2011. Most of the isolates were resistant to the β-lactams. Among the 81 isolates,92.6% of them are detected of intI1 and 78.7% of the isolates are detected of variable regions. The most common gene cassette is aadA2,followed by the aacA4-catB8-aadA1 and aadA2+dfrA25. Conclusion:The proportion of CRKP increased rapidly in our hospital and efficient measures should be carried out to inhibit the dissemination of CRKP;ClassⅠ integrons are common in the CRKP and the isolates have high capability to capture antibiotic resistance gene cassette.

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徐艳玲,顾 兵,黄 茂,刘海燕,梅亚宁,王 彤.2009~2011年耐碳青霉烯肺炎克雷伯杆菌的流行及整合子分析[J].南京医科大学学报(自然科学版),2013,(4):506-510

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  • 收稿日期:2012-11-21
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  • 在线发布日期: 2013-04-29
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