| 胡小骞,王琴.重症监护病房耐碳青霉烯类肺炎克雷伯菌的耐药基因型及系统进化分析[J].安徽医药,2023,27(8):1605-1610. |
| 重症监护病房耐碳青霉烯类肺炎克雷伯菌的耐药基因型及系统进化分析 |
| Analysis of the antimicrobial resistance genotype and phylogenetic evolution of carbapenem-resistant Klebsiella pneumoniae in the intensive care unit |
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| DOI：10.3969/j.issn.1009-6469.2023.08.025 |
| 中文关键词: 肺炎克雷伯菌 碳青霉烯类 抗药性，细菌 重症监护病房 耐药基因型 系统进化分析 |
| 英文关键词: Klebsiella pneumoniae Carbapenemes Drug resistance,bacterial Intensive care unit Antimicrobial resistance genotype Phylogenetic evolution |
| 基金项目:国家自然科学基金资助项目( 81902056) |
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| 中文摘要: |
| 目的通过分析某三甲医院重症监护病房( ICU)的耐碳青霉烯类肺炎克雷伯菌( CRKP)的耐药基因及系统进化关系，为耐药菌防控的管理提供参考依据。方法收集安徽医科大学第二附属医院 2018年 3―7月 ICU住院病人分离的 19株 CRKP，使用 VITEK-2 Compact系统进行细菌鉴定及药敏试验，应用 Illumina Hiseq 2500平台进行全基因组测序( WGS)应用 MLST软件测定 ST型，应用 Kaptive软件检测荚膜型，应用 Staramr软件筛查菌株的耐药基因，应用 Ridom SeqSphere +软件进行，cgMLST分型及最小生成树( MST)的构建，并应用 CSI Phylogeny 1.4软件及 FigTree v1.4.4软件构建最大似然树( MLT)，以分析其系统进化关系。结果 19株 CRKP除了对替加环素敏感，对其他常用抗菌药物均呈现耐药， 19株 CRKP均携带 blaKPC-2耐药基因，均属于 ST11-KL64型， MST图中以 AY7007、AY7003为中心聚集为一簇， cgMLST分型均为 CT1774型， MLT图显示分为四组克隆型，组内亲缘性关系相近。结论该院 ICU分离的 CRKP以 ST11-KL64-CT1774型为主，并具有多重耐药性，存在医院内播散的风险。 |
| 英文摘要: |
| Objective To analyze the relationship of resistance genes and phylogenetic evolution of Carbapenem-resistant Klebsiella pneumoniae (CRKP) in the intensive care unit (ICU) of a tertiary hospital, so as to provide a reference for the management of antibioticresistant bacteria prevention and control.Methods Nineteen strians of CRKP isolateed from ICU inpatients in the Second AffiliatedHospital of Anhui Medical University from March to July 2018 were collected. The VITEK-2 Compact system was used for bacterialidentification and drug sensitivity test.The Illumina Hiseq 2500 platform was used for whole genome sequencing (WGS). The MLST software was used to detect the ST types of strains. The Kaptive software was used to detect the capsular types. The Staramr software wasused to screen the antimicrobial resistance genes of the strains. The Ridom SeqSphere + software was used to perform cgMLST typingand construct minimum spanning tree (MST). The CSI Phylogeny 1.4 software and FigTree v1.4.4 software was used to construct a maximum likelihood tree (MLT) to analyze the phylogenetic relationships.Results In addition to being sensitive to tigecycline, nineteenstrians of CRKP were resistant to other commonly used antibacterial drugs. The nineteen strians all carried the blaKPC-2 resistance gene and belonged to the ST11-KL64 type.The MST showed that nineteen strians clustered into a cluster with AY7007 and AY7003 asthe center. The cgMLST types of the strains were all CT1774 types. The MLT showed that they were assigned into four groups of clonotypes, and the genetic relationships within the groups were similar.Conclusions The CRKP isolated from the ICU mainly belongs to ST11-KL64-CT1774 type.The CRKP strains have multidrug resistance, and there is a risk of spreading in the hospital. |
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