摘要
目的 了解本院碳青霉烯肺炎克雷伯菌（CRKP）的临床感染特点和产酶情况。方法 对分离自临床样本的非重复CRKP的试验数据进行分析。另随机选取59株美罗培南敏感性降低[最小抑菌浓度（MIC）≥4μg/mL]的CRKP, mCIM联合eCIM检测其产酶情况。结果 共检出448株CRKP，临床标本主要来自呼吸内科，其次为重症监护室；随机选取的59株CRKP中有48株产碳青霉烯酶，其中31株产金属β-内酰胺酶。结论 CRKP感染情况严峻，需加强管理，有效降低院内CRKP感染率。eCIM联合mCIM检测成本低、操作简单，是一种经济、高效的表型筛选方法。
关键词： 耐碳青霉烯类肺炎克雷伯菌；碳青霉烯酶表型；改良碳青霉烯类失活法；乙二胺四乙酸-碳青霉烯类失活法
Abstract
Objective To investigate the clinical characteristics and enzyme production of Klebsiella carbapenem pneumoniae (CRKP) in our hospital. Methods The data of non-replicated CRKP isolated from clinical samples were analyzed. In addition, 59 strains of CRKP with reduced meropenem sensitivity [minimum inhibitory concentration (MIC) ≥4μg/mL] were randomly selected, and mCIM combined with eCIM was used to detect their enzyme production. Results A total of 448 strains of CRKP were detected, mainly from respiratory department, followed by intensive care unit. Among 59 randomly selected CRKP strains, 48 strains produced carbapenemase and 31 strains produced metallic β-lactamase. Conclusion CRKP infection is serious and management should be strengthened to effectively reduce the infection rate of CRKP in hospital. eCIM combined with mCIM is an economical and efficient phenotypic screening method with low cost and simple operation.
Key words： Carbapenem resistant Klebsiella pneumoniae; Carbapenem enzyme phenotype; Improved carbapenem inactivation method; Ethylenediaminetetraacetic acid carbapenems deactivation method
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