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[1]黃麗萍,肖力英,陳東杰,等.福州地區(qū)耐碳青霉烯肺炎克雷伯菌對頭孢他啶-阿維巴坦的藥敏情況及耐藥分析[J].福建醫(yī)藥雜志,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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福州地區(qū)耐碳青霉烯肺炎克雷伯菌對頭孢他啶-阿維巴坦的藥敏情況及耐藥分析()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期數(shù):
2021年05期
頁碼:
5-9
欄目:
臨床研究
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
文章編號:
1002-2600(2021)05-0005-05
作者:
黃麗萍肖力英陳東杰1李鴻茹陳愉生2
福建醫(yī)科大學(xué)省立臨床醫(yī)學(xué)院 福建省立醫(yī)院呼吸與危重癥醫(yī)學(xué)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
關(guān)鍵詞:
肺炎克雷伯菌 耐碳青霉烯 頭孢他啶-阿維巴坦 耐藥基因 多位點(diǎn)序列分型
Keywords:
Klebsiella pneumoniae Carbapenem resistant Ceftazidime-avibactam drug resistance gene multilocus sequence typing
分類號:
R91
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 分析我院耐碳青霉烯肺炎克雷伯菌(CRKP)對頭孢他啶-阿維巴坦(CZA)的藥敏情況,探討我院耐CZA的CRKP優(yōu)勢克隆株及攜帶耐藥基因情況。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,應(yīng)用微量肉湯稀釋法檢測CZA的藥敏情況,篩選出耐CZA的CRKP菌株。利用實(shí)時(shí)熒光多聚核苷酸鏈?zhǔn)椒磻?yīng)(RT-PCR)及瓊脂糖凝膠電泳對耐藥基因(NDM、VIM、IMP、GIM、SPM、TMB、SMB、SIM、AIM、DIM)進(jìn)行檢測,將擴(kuò)增產(chǎn)物進(jìn)行雙向測序和比對,確定其基因型,通過多位點(diǎn)序列分型(MLST)分析細(xì)菌同源性。結(jié)果 121株CRKP中有23株對CZA耐藥,耐藥率占19.01%。23株CZA耐藥的CRKP中1株耐替加環(huán)素,14株對替加環(huán)素敏感,敏感率為60.87%,8株對替加環(huán)素中介(占34.78%)。23株CZA耐藥的CRKP 菌株MLST分型結(jié)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耐藥的CRKP中有11株檢出耐藥基因NDM-1(47.83%),有4株檢出耐藥基因NDM-5(17.39%),其余8株均未檢測到耐藥基因。結(jié)論 ST11型是我院CZA耐藥CRKP的主要菌株類型,與當(dāng)前國內(nèi)主要流行序列型相同,攜帶NDM-1、NDM-5基因可能與CRKP耐CZA有關(guān),替加環(huán)素(TGC)可作為治療CZA耐藥CRKP的可選藥物。
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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備注/Memo

備注/Memo:
基金項(xiàng)目:福建省衛(wèi)健委青年科研課題(2017-2-14); 福建醫(yī)科大學(xué)啟航基金項(xiàng)目(2016QH119)
1 福建省立醫(yī)院檢驗(yàn)科; 2 通信作者
更新日期/Last Update: 2021-10-15