【摘要】 目的了解阴沟肠杆菌AcrAB-TolC外排系统基因的携带情况,探讨其与阴沟肠杆菌对常用抗菌药物耐药之间的关系。方法采用法国梅里埃Vitek 2 compact仪对临床分离的136株阴沟肠杆菌进行鉴定和药敏;采用PCR法检测AcrABTolC外排系统acr A,acr B,acr R和tol C四种基因在阴沟肠杆菌中的分布情况,并根据检测结果进行耐药率分组比较。结果136株阴沟肠杆菌对头孢曲松的耐药率达52.2%,对亚胺培南的耐药率高达15.4%;AcrAB-TolC外排系统tol C基因的检出率最高(95.6%),其次为acr R基因(80.9%),acr A基因的检出稍低(70.6%),acr B基因的检出率最低(61.7%)。同时携带四种基因的菌株最多,占36.8%;各外排系统基因阳性组的耐药率均高于阴性组。结论阴沟肠杆菌耐药问题较严峻,AcrAB-TolC外排系统acr A,acr B,acr R和tol C四种基因在阴沟肠杆菌中普遍且存在差异性,并在多药耐药形成中发挥了重要作用。更多还原

【Abstract】 Objective To detect the carrying situation of AcrAB-TolC efflux system genes in Enterobacter cloacae,and investigate the relationship between efflux system genes and Enterobacter cloacae resistant to commonly used antibiotics. Methods 136 strains of Enterobacter cloacae were identified and antibiotic susceptibility testing by Vitek 2 compact. The distribution of efflux pump gene acr A,acr B,acr R and tol C in the isolates was detected by PCR,and the resistance rates were compared among groups.Resulst 136 strains of Enterobacter cloacae resistant to ceftriaxone up to 52.2%,imipenem was 15.4%. In the AcrAB-TolC efflux system,the detection rate of tol C,acr R,acr A and acr B genes aranging from high to low were 95.6%,80.9%,70.6% and 61.7%,respectively. Isolates contained four genes with the highest detection rate were up to 36.8%. The resistance rates of gene-positive groups were higher than gene-negative group. Conclusion Multi-drug resistance of E. cloacae clinical isolates in Gannan area is serious,all of the four genes are common and differentially expressed in Enterobacter cloacae and play an important role in the formation of multi-drug resistance.更多还原