| Objective:To understand the resistance and homology of carbapenem-resistant Klebsiella pneumoniae(CR-KPN)in the intensive care unit of the First Affiliated Hospital of Xinjiang Medical University.Methods : Retrospectively collected 43CR-KPNs isolated from clinically submitted specimens from May 2017-July 2018 and 4CR-KPNs isolated from the environment during the same period.Enzyme phenotyping test,polymerase chain reaction(PCR)detection and analysis of related drug-resistant genes,and the CR-KPN strains which carried the KPC-2 type carbapenemase gene and were isolated from the clinical specimen from the inpatients in respiratory intensive care area from May to July 2018 and their environment were subjected to homology analysis.Results : The 47 CR-KPN strains isolated in the intensive care unit showed high resistance to commonly used antibacterials in clinical practice.The results of drug resistance gene detection showed that among 47 strains of CR-KPN strains,35 strains of KPC-2 carbapenemase,2 strains of NDM-1,and 2 strains of KPC-2 and OXA-23.1strain,no IMP,VIM,OXA-48 type carbapenemase genes were detected.The susceptibility test results of 15 strains of CR-KPN strains isolated from RICU ward from May to July 2018 showed that almost all other clinically used antibacterial drugs were resistant to tigecycline and ceftazidime / avibactam.It is shown that they all carry the KPC-2 type carbapenemase gene.The analysis of PFGE results showed that 15 strains of CR-KPN belonged to 8 different types of A-H,and the homology between the strains was low.The MLST typing showed that they were all ST11 types.Conclusions : The carbapenem-resistant pneumoniae Klebsiella detection rate is high in this hospital’s respiratory intensive care unit,and CR-KPN is scattered polyclonally in epidemiology.Clinical departments should actively strengthen the hospital’s sensory control measuresand emphasize hand hygiene compliance to effectively control the spread of clones. |
