Abstract:
OBJECTIVE To study the epidemiological characteristics and genotypes of β-lactamase in imipenem-resistant
Klebsiella pneumoniae so as to provide guidance for reasonable clinical use of antibiotics and control of infections.
METHODS A total of 25 strains of imipenem-resistant
K.pneumoniae were collected from Feb 2014 to Nov 2014.The drug susceptibility was tested by microorganism analytical system VITEK-2, the modified Hodge test was carried out to screen carbapenemases of the strains, PCR was used to detect KPC-2, SHV, CTX-M, IMP, VIM, NDM-1, and OXA-48 of β-lactamase genes.The homology of the 25 strains was analyzed by mean of enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR).
RESULTS Among the 18 antibiotics tested, the drug resistance rates to piperacillin-tazobactam, ampicillin/sulbactam, cefazolin, ceftriaxone, ampicillin, ertapenem, imipenem, and aztreonam were 100.0%; the drug resistance rate to sulfamethoxazole-trimethoprim was the lowest (32.0%), followed by amikacin and tobvamyin toth (68.0%).The modified Hodge test showed that 20 strains(80.0%) were positive; totally 25 strains were tested positive for SHV gene, 20 strains were tested positive for CTX-M gene, 15 strains were tested positive for KPC-2 gene, 1 strain was tested positive for IMP-4 gene, 3 strains were tested positive for NDM-1 gene, and VIM and OXA-48 genes were tested negative.The 25 strains were classified into 6 genotypes, namely as the followsing: A (15 strains), B (5 strains), C (2 strains), D (1 strain), E(1 strain), and F (1 strain).
CONCLUSION The imipenem-resistant
K.pneumoniae strains are highly multidrug-resistant; the production of the β-lactamase is the leading mechanism for the resistance to multiple antibiotics, and there is a clonal spread in the area, and 3 strains carrying NDM-1 gene, to which great attention should be paid.