产IMP-4型及IMP-8型碳青霉烯酶肠杆菌科细菌的临床分布与相关耐药.DOCVIP

产IMP-4型及IMP-8型碳青霉烯酶肠杆菌科细菌的临床分布与相关耐药性研究 庞峰1a，李艳华1a，贾秀芹1b，赵岐刚1a（1．聊城市人民医院1a．检验科，1b．药学部，山东聊城252000） 【摘要】 目的 调查本院耐碳青霉烯类抗菌药物肠杆菌科细菌(CRE)的临床分布、耐药性及基因型。方法 收集2010 ~2012年临床分离到的30株CRE，采用改良Hodge试验检测碳青霉烯酶表型，PCR检测碳青霉烯酶blaKPC、blaIMP、blaVIM、blaOXA-48及blaNDM-1基因，阳性结果进行DNA测序，Blast比对确定基因型。结果 30株细菌以肺炎克雷伯菌为主，占80%；感染患者主要来自于各类ICU；感染部位以下呼吸道为主，占93.3%；对常用抗菌药物呈多重耐药；其中25株改良Hodge试验阳性；PCR扩增和DNA测序显示11株为blaIMP-4，12株为blaIMP-8，未扩出blaKPC、blaVIM、blaOXA-48及blaNDM-1目的基因。结论 本次研究证实blaIMP-4型和blaIMP-8型碳青霉烯酶是本院肠杆菌科细菌产碳青霉烯酶的主要型别，且已在ICU中局部流行。 【关键词】 肠杆菌科细菌；碳青霉烯酶；临床分布；耐药性；IMP-4；IMP-8 Study on clinical distribution and drug resistance of Enterobacteriaceae producing IMP-4 and IMP-8 carbapenemase PANG Feng1, LI Yan-hua1, JIA Xiu-qin2, LI Ding1, ZHAO Qi-gang1. (1a. Department of Clinical Laboratory, 1b. Department of Pharmacy, Liaocheng Peoples Hospital, Liaocheng, 252000, China) Corresponding author: PANG Feng, Email: pangfeng01@163.com 【Abstract】 Objective To investigate the clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae (CRE) in our hospital. Methods Thirty CRE had been collected in Liaocheng Peoples Hospital from 2010 to 2012. The phenotype of carbapenemase was investigated by modified Hodge test. The blaKPC, blaIMP, blaVIM, blaOXA-48 and blaNDM-1 genes of carbapenemase were detected by PCR, then the positive results were detected by DNA sequencing and blast to determine the phenotypes. Results Klebsiella pneumoniae was a dominate bacteria in 30 strains of Enterobacteriaceae, accounting for 80%. Infected patients were mainly from all kinds of ICU and the lower respiratory tract was the most infected parts, which account for 93.3%. All strains showed a multi-drug resistance to commonly used antibiotics. Among these 30 strains, 25 strains were positive in the modified Hodge test. The blaIMP gene was identified in 23 strains by PCR and DNA sequencing, including 11 blaIMP-4 and 12 blaIMP-8. There were no blaKPC, blaVIM, blaOXA-48 and blaNDM-1 genes detected. Conclusio