Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China

Ou Qin; Li Wenfang; Li Bei; Yu Chunfang

doi:10.24920/J1001-9294.2017.018

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Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China

Chinese Medical Sciences Journal Vol. 32, Issue 2, Pages: 107-112(2017)

Orginal Article | Updated：2024-04-10

- Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China
- Affiliations：
  
  1. 1Department of Medical Microbiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China
  2. 2Laboratory of Infectious Diseases, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China
- Author bio：
  
  *Corresponding author Tel: 86-0719-8891151, E-mail: 151449176@qq.com
- Funds：
- DOI：10.24920/J1001-9294.2017.018
  CLC：
- Received：17 April 2014，
  
  Published Online：20 June 2017，
  
  Published：2017-06
- Accepted：
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Ou Qin, Li Wenfang, Li Bei, et al. Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China[J]. Chinese medical sciences journal, 2017, 32(2): 107-112.
DOI：

Ou Qin, Li Wenfang, Li Bei, et al. Prevalence of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) and the Distribution of Class 1 Integron in Their Strains Isolated from a Hospital in Central China[J]. Chinese medical sciences journal, 2017, 32(2): 107-112. DOI： 10.24920/J1001-9294.2017.018.

摘要

目的

研究耐青霉烯类肺炎克雷白杆菌（Carbapenem-Resistant Klebsiella Pneumoniae

CRKP）临床分布

及整合素1在CRKP多药耐药中的作用。

方法

在三年间从中国中部城市一家医院的多个科室采集唾液、血液及多种引流液临床标本

分离肺炎克雷白杆菌并鉴定CRKP。细菌药敏实验分析CRKP对13中抗生素的耐药情况。PCR扩增CRKP整合素1的可变区域

通过酶切及DNA测序技术分析整合素1可变区域的基因结构。

结果

共955例肺炎克雷白杆菌被分离出

其中CRKP共117例(12.3%)。2013

2014

2015年的Kp菌株中CRKP的分离率分别为8.9% (26/292)

11.31% (38/336)及16.21% (53/327)

呈逐步上升趋势。44.4% (52/117)的CRKP从ICU分离获得

61.5% (72/117)从痰液分离获得。117株CRKP中95% 对氨苄西林/舒巴坦、氨曲南、亚胺培南、美罗培南、头孢他啶、头孢噻肟、头孢吡肟及哌拉西林耐药

但对替加环素和多粘菌素的耐药率较低

分别为12.8％和35.9％。CRKP中整合素1阳性检测率为77.8% (91/117)

整合素1与妥布霉素

庆大霉素及阿米卡星这三种氨基糖苷类抗生素耐药密切相关(P

0.01)。整合素1可变区域基因盒检测显示

aadA2占64.84% (59/91)

aacA4 catB8-aadA1占23.1% (21/91)

及aadA2-dfrA25占12.1% (11/91)。

结论

CRKP有逐年增多的趋势

大部分同时具备多药耐药。整合素1介导的耐药基因盒在CRKP对氨基糖苷类抗生素耐药中发挥重要作用

其中aadA2是最常见的耐药基因。

Abstract

Objective

The aim of our study is to investigate the prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) and the genetic characteristics of the class 1 integron in CRKP on multi-drug resistance.

Methods

Clinical Klebsiella pneumoniae strains were collected from multiple departments of a hospital in central China. CRKP strains were identified among the isolates

and antibiotics susceptibility of CRKP strains was analyzed. The polymerase chain reaction (PCR) was adopted to amplify the class 1 integron variable area. The integron genetic structure was analyzed with enzyme digestion and DNA sequencing technology. The relation between class 1 integron and drug resistance was analyzed statistically.

Results

Totally 955 strains of Klebsiella pneumoniae were isolated from varied sites of the hospital

and 117(12.3%) of them were identified as CRKP

with a separation rate of 8.9% (26/292) in 2013

11.3% (38/336) in 2014 and 16.2% (53/327) in 2015

which shows an increasing trend by year. 44.4% (52/117) of CRKP strains were separated from specimen of ICU

and 61.5% (72/117) were from sputum. Over 95% CRKP strains were resistant to ampicillin/sulbactam

aztreonam

imipenem

meropenem

ceftazidme

cefotaxime

cefepime

and piperacillin

while relatively low resistant rates were found in tigecycline (12.8%) and colistin (35.9%). The class 1 integron was detected in 77.8% (91/117) of CRKP strains. Class 1 integron of CRKP was significantly correlated with the antibiotic resistance to the tobramycin

gentamicin and amikacin (all

0.01). The gene cassette analysis of variable area of class 1 integron showed that aadA2 accounts for 64.8% (59/91)

aacA4-catB8-aadA1 23.1% (21/91)

and aadA2-dfrA25 12.1% (11/91).

Conclusions

CRKP has an increasing trend in a clinical setting in China

and most of them were resistant to multiple antibiotics. Class 1 integron in CRKP has strong ability to capture the genes resistant to aminoglycosides antibiotics from environment

with the aadA2 gene as the most popular one.

关键词

Keywords

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