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大肠埃希菌及肺炎克雷伯菌耐药基因分析

Analysis of antimicrobial resistance genes of Escherichia coli and Klebsiella pneumoniae

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【作者】 王震周丽萍庄建伟刘智成汪海青

【Author】 WANG Zhen,ZHOU Li-ping,ZHUANG Jian-wei,et al.Department of Clinical Laboratory,Zhenjiang Second People′s Hospital(Zhenjiang 212002,China)

【机构】 江苏省镇江市第二人民医院检验科江苏省镇江市第二人民医院检验科 212002212002

【摘要】 目的了解现阶段产超广谱β-内酰胺酶(ESBLs)和头孢菌素酶(AmpC酶)的大肠埃希菌和肺炎克雷伯菌的耐药特性及基因型分布,并作同源性分析。方法纸片扩散法(K-B)检测细菌对抗生素的敏感性;双纸片扩散确诊试验检测ESBLs;三维试验检测AmpC酶;聚合酶链反应(PCR)检测基因型;肠杆菌科基因间重复一致序列(ERIC)PCR作分子生物学分型。结果产酶菌株对亚胺培南、美罗培南、阿米卡星、头孢吡肟耐药性较低,对其他13种抗生素耐药性较高。在PCR扩增试验中,blaCTX-M、blaTEM、blaOXA、blaSHV、blaVEB-1型ESBLs基因及CIT、DHA型AmpC酶基因阳性率分别为75.2%,35.8%,11.0%,4.6%,0.9%,4.6%和4.6%;有46.8%的菌株同时携带多种耐药基因。用ERIC-PCR法将所检测的大肠埃希菌和肺炎克雷伯菌分成42型和22型。结论产ESBLs和AmpC酶大肠埃希菌和肺炎克雷伯菌的耐多药性值得关注;ESBLs及AmpC酶分别以CTX-M型及CIT型和DHA型为主;产酶菌株有散在的克隆流行,应注意监控,防止耐药菌株引起院内感染。

【Abstract】 Objective To understand the current resistance and genotype of extended-spectrum beta-lactamase(ESBLs)and AmpC-producing Escherichia coli and Klebsiella pneumoniae and to perform homology analysis.Methods Antibiotic susceptibility test was performed by Kirby-Bauer method.ESBLs-producing isolates were confirmed by double disk diffusion confirming test.AmpC β-lactamases were detected by the three-dimensional test.PCR was performed to understand the genotype of ESBLs and AmpC β-lactamases.DNA fingerprints of isolates were constructed by enterobacterial repetitive intergenic consensus PCR(ERIC-PCR).Results Enzyme-producing strains were more sensitive to Imipenem,Meropenem,Amikacin and Cefepime but resistant to 13 other antimicrobials.75.2%,35.8%,11.0%,4.6%,0.9%,4.6% and 4.6% of the isolates was found carried blaCTX-M,blaTEM,blaOXA,blaSHV,blaVEB-1,CIT and DHA gene,respectively,by PCR.In addition,46.8% of all strains carried more than one β-lactamase gene.The genotype of E.coli and K.pneu was divided into 42 and 22 clusters by ERIC-PCR.Conclusion Attention should be paid to multidrug resistance of enzyme-producing E.coli and K.pneu.BlaCTX-M and CIT,DHA were the predominant genotypes in ESBLs-producing and AmpC-producing strains.The prevalence of multidrug resistance clone in the clinic reminded us to control nosocomial infection effectively.

【基金】 镇江市社会发展基金资助项目(SH2005032)
  • 【文献出处】 中国公共卫生 ,Chinese Journal of Public Health , 编辑部邮箱 ,2008年07期
  • 【分类号】R450
  • 【被引频次】5
  • 【下载频次】77
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