中文摘要：

目的：了解上海交通大学医学院附属新华医院产KPC酶肺炎克雷伯菌的分布情况及分子流行病学特点，初步探讨其医院感染暴发流行的传播途径。方法连续收集2010年1月至2013年12月从上海新华医院临床样本中分离到的对碳青霉烯类抗菌药物耐药的肺炎克雷伯菌。采用Vitek 2 Compact系统联合纸片扩散法（ Kirby-Bauer法）对菌株进行鉴定及药敏试验，用改良Hodge试验对碳青霉烯类抗菌药物耐药的菌株进行耐药表型筛查，采用聚合酶链反应（ PCR）及测序方法检测碳青霉烯酶KPC基因，并对产KPC酶的菌株进行肠杆菌基因间重复共有序列（ ERIC）-PCR分型及临床资料汇总分析。结果共收集到77株对碳青霉烯类耐药的肺炎克雷伯菌，71株改良Hodge试验阳性，其中69株携带KPC基因，经测序确定为KPC-2基因。 ERIC-PCR结果提示69株产KPC-2酶菌株均为同一克隆株。12个科室首例分离到产KPC-2酶肺炎克雷伯菌的患者中，有7例在本院有转科记录，其中4例都曾在外科重症监护室（SICU）接受过治疗。结论上海新华医院的耐碳青霉烯类肺炎克雷伯菌以产KPC-2酶为主，这些菌株可能通过转科患者在院内形成广泛的水平播散。

英文摘要：

Objective To investigate the prevalence and transmission route of Klebsiella pneumoniae carbapenemases （ KPC）-producing Klebsiella pneumoniae in Xinhua Hospital Affiliated to Shanghaijiao Tong University School of Medicine .Methods Carbapenem-resistant Klebsiella pneumoniae isolates from clinical samples were collected from Xinhua Hospital during January 2010 and December 2013.Vitek 2 Compact and disc diffusion method （ Kirby-Bauer method ） were used for identification of the strains and antibiotic susceptibility test . Modified Hodge test was performed for drug-resistant phenotype screening . Carbapenemase gene blaKPC was amplified by PCR, and the positive products were sequenced and analyzed . Enterobacterial repetitive intergenic consensus （ ERIC ）-PCR was used to analyze molecular epidemiology of the KPC-producing strains .And clinical information of these isolates was analyzed .Results There were 77 carbapenem-resistant Klebsiella pneumoniae isolates in total , and 71 of them were positive in modified Hodge test.Sixty-nine isolates were identified carrying blaKPC-2 gene.All of the KPC-2-producing isolates were classified as the same genotype by ERIC-PCR. Among 12 patients with KPC-2-producing Klebsiella pneumoniae infection who were first identified in each departments , 7 were transferred from other departments, and 4 were treated in surgery intensive care unit （SICU）.Conclusions Most of carbpenem-resistant Klebsiella pneumoniae strains isolated from Xinhua Hospital are KPC-2-producing .The outbreak of carbpenem-resistant Klebsiella pneumoniae infection in the hospital may be associated with the interdepartmental transfer of patients .