Gene analysis of Carbapenem resistance to Klebsiella pneumoniae in a general hospital
ZHANG Mei1, XIE Xianghong1, WEI Wenbo1, ZHANG Xin2, ZOU Yan1, HE Yanhong1, DENG Yong1
1. Department of Clinical Laboratory,Sichuan Provincial Corps Hospital,Chinese People’s Armed Police Force,Leshan 614000,China; 2. Department of Laboratory Medicine,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital,Chengdu 610072,China
Abstract：Objective To detect the drug-resistant gene of Carbapenem-resistant Klebsiella pneumoniae (CRKP) in a hospital,to find out about the prevalence and distribution of the CRKP genes,and to provide data for treatment and prevention of related infections.Methods In this retrospective cohort study,32 strains of CRKP were collected from 13 departments of a general hospital between August 2017 and March 2020.The Microscan Walk Away96 automatic bacterial identification drug sensitivity analyzer was used for routine drug sensitivity tests.The modified carbapenem inactivation method (mCIM) combined with the enzyme inhibitor enhancement test was used to determine the production of the metal β-lactamase and serine cabapenemase.The Gene-Xpert Carba-XVIR2 automatic pathogen rapid detection system was used to detect drug-resistant genes.Results Drug sensitivity tests showed that the strains of CRKP collected from this hospital were highly resistant to carbapenems,cephalosporins,cephamycins,monocyclics,quinolones,and aminoglycosides antibiotics.Thirty of the 32 strains of CRKP were positive.One strain produced class A serine enzyme plus class B β-lactamase while 29 strains produced class A serine enzyme during the enzyme inhibitor enhancement test.One strain produced KPC+NDM,29 strains produced KPC,but no strains produced IMP,VIM or OX-48 from the Gene-Xpert system.Conclusions CRKP strains collected from this hospital are highly resistant to routinely used antibiotics.The main drug-resistant genotype is KPC type and the main mechanism of action is through carbapenemase production.In hospitals that are incapable of genotype analysis,mCIM can be combined with enzyme inhibitor enhancement tests to meet the clinical needs.
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2021, Vol. 32 
