洪伟,钱声艳,吴昌学,饶凤琴,程玉梅,张婷,齐晓岚,禹文峰,官志忠
HONG Wei,QIAN Shengyan,WU Changxue,RAO Fengqin,CHENG Yumei,ZHANG Ting,QI Xiaolan,YU Wenfeng,GUAN Zhizhong

• 1:贵州医科大学地方病与少数民族疾病教育部重点实验室&贵州省分子生物学重点实验室
• 2:贵州医科大学附院ICU

摘要(Abstract)：

目的:了解重症监护病房(ICU)肠道来源样品(粪便)中肺炎克雷伯菌(Klebsiella pneumoniae,Kp)携带情况及其特征。方法:采用哥伦比亚培养基分离粪便样品中的肺炎克雷伯菌,对其进行16S rDNA测序并构建发育进化树;使用稀释平板法,参照CLSI(2017)标准测定分离的肺炎克雷伯菌对肠道感染常用抗生素耐药性。结果:共收集粪便样本54份,从中分离到14株肺炎克雷伯菌(携带率为26%);14株肺炎克雷伯菌与欧、美菌株亲缘关系较远,与亚洲肺炎克雷伯菌(Klebsiella singaporensis strain LX3)亲缘关系较近,14株肺炎克雷伯菌聚为2个分支;抗生素耐药性检测结果表明,14株菌株对红霉素、克拉霉素、链霉素、四环素、氯霉素、阿莫西林、甲砜霉素、甲硝唑和克林霉素耐药率为100%,仅对诺氟沙星不耐药(耐药率为0%)。结论:贵州ICU病人粪便分离的14株肺炎克雷伯菌与亚洲株亲缘关系较近,且对肠道感染常用抗生素具有较强耐药性,仅对诺氟沙星不耐药。
Objective: To investigate the carrier rate and characteristics of Klebsiella pneumoniae(Klebsiella pneumoniae,Kp) in intestinal samples(feces) of(ICU) in intensive care unit(ICU). Methods: The Klebsiella pneumoniae in the stool sample was isolated by the Columbia culture medium, and the 16 S rDNA sequence was sequenced and the development tree was constructed. The antibiotic resistance of Klebsiella pneumoniae to intestinal infection was determined by dilution plate method. Results: A total of 54 fecal samples were collected and 14 isolated strains of Klebsiella pneumoniae were isolated(26%). 14 strains of Klebsiella pneumoniae were closely distant from European and American strains, and close to Asia strains(Klebsiella singaporensis strain LX3), and 14 strains of Klebsiella pneumoniae were grouped into 2 branches. 14 strains of Klebsiella pneumoniae were grouped into 2 branches. The results of antibiotic resistance test showed that the resistance rate of 14 strains to erythromycin, clarithromycin, streptomycin, tetracycline, chloramphenicol, amoxicillin, thiamphenicol, metronidazole and clindamycin was 100%, and 0% to norfloxacin. Conclusion: 14 Klebsiella pneumoniae strains isolated from feces of patients in Guizhou are closely related to Asian strains, and are strongly resistant to antibiotics commonly used in intestinal infection, but only sensitive to norfloxacin.

关键词(KeyWords)： 重症监护病房;粪便标本;肺炎克雷伯;进化地位;耐药性
ICU;fecal specimens;Klebsiella pneumoniae;evolutionary status;drug resistance

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(31560318,31601012,31760318);; 贵州省自然科学基金资助项目[黔科合基础(2019)1441,(2018)1132,(2018)5779-17]

作者(Author): 洪伟,钱声艳,吴昌学,饶凤琴,程玉梅,张婷,齐晓岚,禹文峰,官志忠
HONG Wei,QIAN Shengyan,WU Changxue,RAO Fengqin,CHENG Yumei,ZHANG Ting,QI Xiaolan,YU Wenfeng,GUAN Zhizhong

DOI: 10.19367/j.cnki.1000-2707.2019.12.003

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