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目的分析神经重症监护病房(NICU)患者感染肺炎克雷伯菌(KP)质粒携带的耐药基因与临床耐药表型的关系,为临床预防和治疗KP的医院感染提供理论依据。方法收集2015年1月-12月医院NICU患者分离的KP 31株,检测其临床耐药表型,通过聚合酶链反应法检测菌株质粒上携带的β-内酰胺类和喹诺酮类耐药基因。结果共检出非重复KP 31株,所有菌株质粒上均检出SHV耐药基因,其中质粒上仅检出1种耐药基因KP共7株占22.58%,2种耐药基因12株占38.71%,3种基因6株占19.35%,4种基因3株占9.68%,5种基因1株占3.23%,6种基因2株占6.46%;产ESBLs的3株KP呈现多药耐药表型,非产ESBLs的28株KP除全部对氨苄西林和哌拉西林耐药以外,对其它抗菌药物均敏感。结论 KP质粒中均携带β-内酰胺类耐药基因,且以SHV最常见,而质粒携带的CTX-M类基因可能与ESBLs表达有关。
Objective To analyze the relationship between drug resistance genes and clinical drug resistance phenotypes of Klebsiella pneumoniae (KP) in patients with neurological intensive care unit (NICU), and to provide a theoretical basis for the clinical prevention and treatment of KP hospital infection. Methods KP 31 isolates from NICU patients from January 2015 to December 2015 in our hospital were collected and their clinical drug resistance phenotypes were detected. The β-lactams and quinolone resistance genes were detected by polymerase chain reaction (PCR). Results A total of 7 non-duplicated KP strains were detected, and all the isolates were identified as SHV-resistant, of which 7 isolates were resistant to KP, accounting for 22.58% and 12 resistant to 12 isolates, accounting for 38.71% 6 strains accounted for 19.35%, 4 genes 3 strains accounted for 9.68%, 5 genes 1 strains accounted for 3.23%, 6 genes 2 strains accounted for 6.46%; ESBLs-producing KP showed multi-drug resistance table 28 KP strains of non-ESBLs were all sensitive to ampicillin and piperacillin and resistant to other antibiotics. CONCLUSION: The KP plasmid carries the β-lactam drug resistance gene, and SHV is the most common. The plasmid-borne CTX-M gene may be related to the expression of ESBLs.