【摘要】 目的调查2006-2007年临床分离的肺炎克雷伯菌耐药性及产ESBLs和AmpC酶的存在形式。方法收集2006-2007年对头孢西丁不敏感的肺炎克雷伯菌110株,用K-B法和微量稀释法测定细菌对头孢他啶等16种抗菌药物的敏感性,用PCR法检测TEM、SHV、GES、PER、CTX-M-1群、CTX-M-2群、CTX-M-3群、DHA和MIR-1/ACT-1基因,用接合转移试验了解肺炎克雷伯菌耐药基因转移方式。结果110株肺炎克雷伯菌对美罗培南、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢他啶、头孢吡肟的耐药率在0~49.9%,对其他抗菌药物耐药率在80.0%~100.0%,110株肺炎克雷伯菌中单产ESBLs为主要形式,ESBLs基因为CTX-M和SHV型,AmpC酶基因为ACT和DHA型,它们均能通过接合转移方式将其质粒携带的耐药性传递至受体菌。结论同时存在ESBLs和AmpC酶是肺炎克雷伯菌对多种抗菌药物耐药的主要原因,耐药基因的转移可导致耐药性的传播扩散,两年比较,肺炎克雷伯菌耐药性呈下降趋势。更多还原

【Abstract】 OBJECTIVE To investigate the drug resistance and the status of producing ESBLs and AmpC beta-lactamases of Klebsiella pneumoniae isolates from 2006 to 2007 in local district.METHODS From 2006 to 2007,110 strains of K.pneumoniae insensitive to cefoxitin were collected.The sensitiveness to 16 antibiotics were tested by K-B method and microdilution method.Genes of TEM,SHV,GES,PER,CTX-M-1,CTX-M-2,CTX-M-3,DHA and MIR-1/ACT-1 were tested by PCR.The gene transfer was detected by conjugation test.RESULTS The resistance rate of 110 K.pneumoniae strains to meropenem,imipenem,piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime and cefepime was 0-49.9%.The resistance rate to other antibiotics was 80-100%.And ESBLs production was the main result.Genes of ESBLs were CTX-M and SHV.Genes of AmpC beta-lactamases were ACT and DHA.They all could transfer the drug-resistance from plasmid to receptor bacteria.CONCLUSIONS Co-existing of ESBLs and AmpC beta-lactamases is the main reason of multi-drug resistance that K.pneumoniae.Transferring of drug-resistance gene leads to the spreading of drug-resistance.The drug-resistance rate of K.pneumoniae decreased during the last two years.更多还原