首页|江西省新生儿筛查CRKP定植菌株分子流行病学特征

江西省新生儿筛查CRKP定植菌株分子流行病学特征

Molecular epidemiological characteristics of colonized CRKP strains in neonates of Jiangxi Province

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目的 探究新生儿耐碳青霉烯类肺炎克雷伯菌(CRKP)定植株分子流行病学特征.方法 对2021年1月1日-12月31日江西省5家医院收治的新生儿患者开展耐碳青霉烯类肠杆菌科细菌(CRE)显色培养基主动筛查,将鉴定为肺炎克雷伯菌(KP)新生儿纳入研究对象,根据碳青霉烯类是否耐药分为CRKP和碳青霉烯敏感KP(CSKP)两组;调查CRKP和CSKP两组新生儿临床特征(包括性别、年龄、发热、入院诊断、炎性指标、抗菌药物应用、抗菌药物使用是否超过7天等),对CRKP与CSKP新生儿临床特征进行对比;同时对CRKP耐药基因进行酶型检测,分析CRKP不同耐药基因的构成情况;对所有CRKP和部分CSKP进行多位点序列分型(MLST).结果 5家医院共筛出CRE阳性标本168份,经质谱仪和纸片法鉴定KP 82株,其中CRKP 25株、CSKP 57株;CRKP新生儿平均日龄(11.64±10.86)d;对比CRKP与CSKP新生儿临床特征,抗菌药物使用时长超过7天能增加CRKP检出率;25株CRKP中产NDM酶14株,产丝氨酸酶1株,不产酶10株,从MLST分型来看,CRKP以ST1564和ST37最为常见(各占20.00%),ST2601和ST11则次之(各占16.00%).结论 新生儿住院患儿CRKP定植率较高,CRKP耐药基因以金属酶、ST1564和ST37最为常见,应加强新生儿CRKP监测和感染防控.
OBJECTIVE To explore the molecular epidemiological characteristics of carbapenem resistant Klebsiella pneumoniae(CRKP)colonization in newborns.METHODS From Jan.1 to Dec.31,2021,active screening of car-bapenem resistant Enterobacteriaceae(CRE)chromogenic medium was carried out on neonatal patients admitted to 5 hospitals in Jiangxi region,and neonates identified as Klebsiella pneumoniae(KP)were included in the stud-y,and were divided into CRKP and carbapenem-sensitive K.pneumoniae(CSKP)groups according to whether car-bapenem resistant was present.The clinical characteristics(including gender,age,fever,admission diagnosis,in-flammatory indicators,antibiotic use,and whether antibiotic were used for more than 7 days)of newborns in the CRKP and CSKP groups were investigated,and the clinical characteristics of newborns with CRKP were compared with those of newborns with CSKP.At the same time,enzyme-type assay for CRKP-resistance genes was carried out to analyze the composition of different CRKP resistance genes;and the multilocus sequence typing(MLST)was performed on all CRKPs and some CSKPs.RESULTS A total of 168 CRE positive specimens were screened from 5 hospitals,and 82 KP strains were identified by mass spectrometry and paper disc method,including 25 CRKP strains and 57 CSKP strains.The average daily age of CRKP newborns was(11.64±10.86)days.Compa-ring the clinical characteristics of newborns with CRKP and CSKP,the duration of antibiotics use for more than 7 days could increase CRKP detection rate.Among the 25 CRKPs,14 strains were NDM enzymes-producing,1 strain was serine enzyme-producing,and 10 strains were non-enzymatic.In terms of the MLST typing,ST1564 and ST37 were the most common CRKPs(20.00% of each),followed by ST2601 and ST11(16.00% of each).CONCLUSIONS The rate of CRKP colonization was high in neonatally hospitalized children,and CRKP resistance genes were most found in metalloenzymes,ST1564,and ST37.Therefore,neonatal CRKP surveillance and infec-tion prevention and control should be strengthened.

Active screeningCarbapenem-resistant Klebsiella pneumoniaeNeonateMolecular epidemiologyMulticenter researchColonization

陈修文、章新平、陈思思、刘小莲、谢承峰、周治球、曾毅、李斯斯、秦欢、朱小燕、严海斌、许继涛、叶曼、刘曼丽、黄文智、周艳、乐萍

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江西省儿童医院感染控制科,江西南昌 330038

江西省儿童医院公共卫生科,江西南昌 330038

宜春市妇幼保健院院感科,江西宜春 336099

九江市妇幼保健院院感科,江西九江 332600

鹰潭市人民医院院感科,江西鹰潭 335099

上饶市妇幼保健院,江西上饶 334099

九江市第一人民医院医院感染管理处,江西九江 332600

宜春市人民医院院感科,江西宜春 336099

江西省儿童医院检验科,江西南昌 330038

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主动筛查 耐碳青霉烯类肠杆菌科细菌 新生儿 分子流行病学 多中心研究 定植

江西省科技厅应用研究培育计划基金资助项目

20181BBG78012

2024

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子:1.885
ISSN:1005-4529
年,卷(期):2024.34(19)