福建某基层医院CRE碳青霉烯类耐药基因分析

目的 对福建省南平市第二医院分离的碳青霉烯类耐药肠杆菌科细菌进行碳青霉烯类基因和其他β-内酰胺类耐药基因检测。方法 收集碳青霉烯类耐药肠杆菌科细菌，采用Vitek-2 Compact全自动细菌鉴定/药敏仪器进行细菌鉴定和药敏试验；采用改良Hodge试验对实验菌株进行表型检测；利用PCR及测序法对常见的碳青霉烯类和β-内酰胺类耐药基因进行检测；质粒接合试验检测碳青霉烯类耐药基因是否具有可转移性。结果 共收集到4株碳青霉烯类耐药肠杆菌科细菌，呈多重耐药性。2株改良Hodge试验阳性。试验菌株均检出碳青霉烯类耐药基因（NDM-1、IMP-8或VIM-2），并同时携带有其他β-内酰胺类基因；4株细菌中有3株的碳青霉烯类耐药基因接合成功。结论 碳青霉烯类耐药肠杆菌科细菌已在福建基层医院出现，并具有一定传播性，应引起相关主管部门的注意，以防耐药菌的流行。

The prevalence of carbapenem-resistant genes in a hospital in Fujian province

Objective To detect carbapenemase and other β-lactamase genes in carbapenem-resistant Enterobacteriaceae isolated from one municipal hospital in Fujian province. Methods The bacterial identification and antibiotic susceptibility tests were performed by Vitek-2 Compact. The Modified Hodge Test was used to detect the production of carbapenemases. The common carbapenemase genes were amplified by using PCR and sequencing. Carbapenemase production was detected by the modified Hodge test (MHT). Results All of the four clinical carbapenem-resistant Enterobacteriaceae isolates were multi-drug resistant. Two isolates were found to be producer of carbapemases. All of the 4 isolates carried carbapenem-resistant genes and other β-lactamase genes. Conjugation experiment were successful in 3 out of 4 isolates. Conclusion Carbapenem-resistant Enterobacteriaceae are prevalent in primary hospitals in Fujian, which should be monitored closely.