【作者】 冯福英； 胡望平； 杨湘越； 张亚彬； 胡辛兰； 郭容英；

【Author】 FENG Fu-ying. HU Wan-ping, YANG Xian-yie. NAN Xiao-peng. ZHANG Ya-pin, HU Xin-lan. GUO Rong-ying(PLA Center of Laboratory Medicine of Fuzhou General Hospital, Nanjing Military Area, Fuzhou 350025; Department of Clinical Laboratory, Fujian Provincial Hospital)

【机构】 南京军区福州总医院全军医学检验中心； 福建省立医院检验科；

【摘要】 目的了解耐头孢西丁革兰氏阴性杆菌高产Ampc酶发生率及基因型分布和耐药性状况。方法收集2004年9月-2005年3月分离自南京军区福州总院、福建省立医院、解放军476医院、福州市第二医院住院患者155株无重复耐头孢西丁革兰氏阴性杆菌进行Ampc酶三维检测、药物敏感试验、高产AmpC酶大肠埃希氏菌,肺炎克雷伯菌的AmpC酶基因型检测.结果在155株菌中有36株高产AmpC酶,高产AmpC酶发生率23.2%,其中大肠埃希氏菌、肺炎克雷伯菌、鲍氏不动杆菌和阴沟肠杆菌的发生率,分别为29.3%、19.9%、6/10、2/6。17株高产AmpC酶大肠埃希氏菌,肺炎克雷伯菌基因检测出MOX型基因3株(大肠埃希氏菌)、DHA型2株(肺炎克雷伯菌)、MIR型1株(大肠埃希氏菌)。高产AmpC酶菌株耐药性严重,且呈多重耐药,对亚胺培南、美罗培南的敏感率在85%以上。结论耐头孢西丁革兰氏阴性杆菌高产AmpC酶发生率较高,菌种分布较宽,耐药性强,应对耐头孢西丁革兰氏阴性杆菌加强高产AmpC酶的监测。更多还原

【Abstract】 Objective To investigate the incident rate of overexpressing AmpCβ -lactamases in cefoxitin-resistant gram-negative bacillus and the status of drug-resistance and genotypes of plasmid-mediated AmpC β-lactamases. Methods A total of 155 clinical isolates of nonrepetitive cefoxitin-resistant gram-negative bacillus collected by Fuzhou General Hospital,Fujian Provincial Hospital.the 476th Hospital of PLA and the Second Hospital of Fuzhou were detected by three-dimensional extract test for AmpC β-lactamases and drug susceptibility by ATB STREP and KB methods.and genotypes of plasmid-mediated AmpC β-lactamases in K.pneumoniae,Ecoli and Prpteus mirabilis with overexpressing AmpC β-lactamases were analyzed by PCR.Results The incident rate of overexpressing AmpC β-lactamases were 23.2% in all,and29.3% in K.pneumoniae,19.9% in E.coli,6/10 in Acinetobacter bauamnnii,2/6 in Enterrobacter cloacae.MOX gene was found in three strains(E.coli),DHA gene in two strains( K.pneumoniae )and MIR in one strain(E.coli) in a total of 17 strains K.pneumoniae and E.coli with overexpressing AmpC β-lactamases.The resistance of strains with overexpressing AmpC β-lactamases is serious and shows multi-resistant.The sensitivity to imipenem and meropenem is over 85%.Conclusion The incident rate of overexpressing AmpC β-lactamases in celoxitin-resistant gram-negative bacillus is comparatively high,the involved genera is wide and drug-resistance is serious ,so that surveillance of overexpressing AmpC β-lactamases in celoxitin-resistant gram-negative bacillus must be enhance.更多还原