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产AmpC酶和ESBLs肺炎克雷伯菌的耐药性分析与耐药基因检测

Antibiotic-resistant Genotypes in AmpC and ESBLs-producing Klebsiella pneumoniae

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【作者】 王冬国周铁丽

【Author】 WANG Dong-guo,ZHOU Tie-li(Taizhou Municipal Hospital,Taizhou,Zhejiang 318000,China)

【机构】 台州市立医院检验科温州医学院附属第一医院检验科

【摘要】 目的了解浙江省温州、台州地区的肺炎克雷伯菌耐药性及存在状况。方法采用VITEK 60型和VITEK 32型、肉汤稀释法测定56株产C类头孢菌素酶(AmpC)和超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的药敏结果;采用聚合酶链反应(PCR)分析ESBLs、质粒介导的AmpC酶和AMEs基因型。结果产AmpC酶和ESBLs肺炎克雷伯菌首选亚胺培南(100%敏感),对其他抗菌药物均有不同程度的耐药;20株菌株100%检出TEM基因,90%检出CTX-MⅠ基因,100%检出SHV基因,85%检出DHA基因,15%检出MIR基因,90%检出不同的氨基糖苷类修饰酶(AMEs)基因。结论产AmpC酶和ESBLs肺炎克雷伯菌表现多药耐药,碳青酶烯类药物亚胺培南是治疗效果最好的药物,同时存在2~6种不同类型的耐药基因。

【Abstract】 OBJECTIVE To study antibiotic resistance and drug-resistant genes in AmpC and ESBLs-producing Klebsiella pneumoniae(KPN) in Wenzhou and Taizhou of Zhejiang Province.METHODS Antimicrobial susceptibilities of AmpC and ESBLs-producing KPN were tested by broth dilution motheds and VITEK 60 and VITEK 32;the genotypes of extended-spectrum beta-lactamases(ESBLs),cephalosporinase C(AmpC) and Genotypes AMEs were analyzed by polymerase chain reaction(PCR).RESULTS All tested KPN strains were susceptible to imipenem and resisitant to more other drugs.TEM genes were amplified in 20(100%) strains,CTX-MⅠgenes were examined in 18(90%) strains,SHV genes were examined in 2(10%) strains,DHA genes were tested in 17(85%) strains,MIR genes were examined in 3(15%) strains and 3 kinds of AMEs genes were tested in 18(90%) strains.CONCLUSIONS AmpC and ESBLs-producing KPN is multiple drug-resisitant,in which 2 to 6 resistant genes exist,Imipenem is the best drug.

  • 【文献出处】 中华医院感染学杂志 ,Chinese Journal of Nosocomiology , 编辑部邮箱 ,2009年01期
  • 【分类号】R446.5;R450
  • 【被引频次】11
  • 【下载频次】236
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