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目的分析我国产肺炎克雷伯菌碳青霉烯酶(KPC)阳性菌的流行病学特征,探讨我国携带KPC阳性菌流行特征及耐药机制。方法收集2009~2015年报道我国blaKPC研究文献,对KPC阳性菌株种类与地区分布、感染来源、耐药谱和转移机制进行流行病学分析。结果我国共有21个省市报道bla_(KPC)阳性菌株,其中浙江最多,占43.51%(P<0.01);阳性菌以肺炎克雷伯菌最多,占87.86(P<0.01);感染阳性菌的患者男性居多(P<0.05);患者所在科室以ICU病区最多,占70.51%(P<0.01);痰液标本分离bla_(KPC)阳性菌最多,占45.62%(P<0.01);bla_(KPC)阳性菌对头孢菌素类、碳青霉烯类、氨基糖苷类抗生素耐药率普遍较高,对多黏菌素、替加环素的耐药率较低;产KPC-2酶或合并多种β-内酰胺酶和外膜蛋白缺失是导致碳青霉烯类抗生素耐药的重要原因。结论携带KPC基因的耐药菌感染已成为全球性的公共卫生问题,需要深入研究其发生发展规律。
Objective To analyze the epidemiological characteristics of Klebsiella pneumoniae producing carbapenemase (KPC) -positive bacteria in China and to explore the epidemiological characteristics and mechanism of KPC-positive bacteria in China. Methods The data of blaKPC in China were collected from 2009 to 2015 and the epidemiology of KPC-positive strains was analyzed by their species and geographical distribution, source of infection, drug resistance spectrum and metastasis mechanism. Results A total of 21 strains of bla_ (KPC) were reported in our country, of which the most was Zhejiang (43.51%) (P <0.01), the most was Klebsiella pneumoniae (87.86%), the positive was The majority of patients were male (P <0.05). The majority of patients were in ICU ward, accounting for 70.51% (P <0.01); sputum samples were most susceptible to bla KPC, accounting for 45.62% (P <0.01) KPC) positive bacteria on cephalosporins, carbapenems, aminoglycoside antibiotics were generally higher rates of resistance to polymyxin, tigecycline was lower; yield of KPC-2 enzyme or Combined with a variety of β-lactamase and the lack of outer membrane protein is an important cause of resistance to carbapenem-based antibiotics. Conclusion The infection of drug-resistant bacteria carrying KPC gene has become a global public health problem, and its occurrence and development need to be studied in depth.