1株阴沟肠杆菌临床分离株对亚胺培南耐药机制的研究

发布时间：2018-01-07 00:28

本文关键词：1株阴沟肠杆菌临床分离株对亚胺培南耐药机制的研究　出处：《重庆医学》2016年07期 　论文类型：期刊论文

【摘要】：目的探讨阴沟肠杆菌临床分离株对亚胺培南的耐药机制。方法采用微量肉汤稀释法测定最低抑菌浓度(MIC)值,用改良Hodge试验检测碳青霉烯酶;PCR扩增检测碳青霉烯酶(blaKPC、blaIMP-1、blaIMP-2、blaVIM-1、blaVIM-2)编码基因和广谱及超广谱β-内酰胺酶(blaTEM、blaSHV、blaCTX-M-1、blaCTX-M-2、blaCTX-M-9)编码基因;耐药基因水平传播采用质粒结合试验。结果阴沟肠杆菌临床分离株除对阿米卡星、环丙沙星、加替沙星、左氧氟沙星敏感及妥布霉素中介外,对所有β-内酰胺类抗菌药物、庆大霉素、四环素、甲氧苄啶/磺胺甲恶唑等抗菌药物均耐药。改良Hodge试验为阳性。PCR扩增5种碳青霉烯酶基因和5种广谱及超广谱β-内酰胺酶基因,显示blaTEM基因扩增阳性,其余基因扩增阴性。质粒接合试验成功传递了对碳青霉烯类抗菌药物的耐药性,接合子菌株相较于阴沟肠杆菌临床株,呈现出低水平耐药。结论此分离株产碳青霉稀酶,携带TEM基因,并可以经质粒转导播散。
[Abstract]:Objective to investigate the drug resistance mechanism of clinical isolates of Enterobacter cloacae to imipenem. PCR amplification was used to detect the blavirus KPCP-1 blaIMP-2 and blaVIM-1. BlaVIM-2) encodes genes, broad-spectrum and extended-spectrum 尾 -lactamases, blaTEMK blaCTX-M-1 blaCTX-M-2. BlaCTX-M-9) encoding gene; Results the clinical isolates of Enterobacter cloacae were sensitive to amikacin, ciprofloxacin, gatifloxacin, levofloxacin and tobramycin. For all 尾 -lactam antibiotics, gentamicin, tetracycline. 5 carbapenem genes and 5 extended-spectrum 尾 -lactamases genes were amplified by modified Hodge assay, which were resistant to trimethoprim / sulfamethoxazole. The results showed that the blaTEM gene amplification was positive and the other genes were negative. The plasmids conjugation test successfully transferred the resistance to carbapenem antibiotics. The conjugate strains were compared with the clinical strains of Enterobacter cloacae. Conclusion the isolated strain can produce carbapenase, carry TEM gene, and be transmissible by plasmid.
【作者单位】：长江大学附属第一医院检验科;长江大学附属第一医院眼科;
【分类号】：R446.5
【正文快照】： 由于抗菌药物的广泛使用,阴沟肠杆菌的耐药菌株也呈现逐年上升趋势。目前阴沟肠杆菌对碳青霉烯类抗菌药物耐药的主要机制有3种:(1)碳青霉烯酶的产生,包括KPC酶、IMI酶、金属酶(IMP酶、VIM酶)等;(2)外膜蛋白的缺失或数量的减少伴有质粒或染色体介导高水平β-内酰胺酶(AmpC酶、

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