耐碳青霉烯类肠杆菌科细菌耐药机制的研究

发布时间：2018-05-09 21:51

  本文选题：碳青霉烯类抗菌药物 + 肠杆菌科细菌　； 参考：《中华医院感染学杂志》2016年21期

【摘要】：目的研究耐碳青霉烯类肠杆菌科细菌(CRE)的耐药机制,为临床合理使用抗菌药物提供依据。方法连续收集某院2011年1月-12月临床分离菌中非重复的肠杆菌科细菌2 203株,VITEK-2全自动微生物分析系统对其进行鉴定及药敏试验;改良Hodge试验初筛碳青霉烯酶;EDTA-亚胺培南(IPM)协同法和亚胺培南双纸片增效法确认金属酶表型;PCR法检测β-内酰胺酶基因及整合子基因,产物测序,BLAST软件比对分析。结果 2 203株肠杆菌科细菌中共检出17株CRE,检出率为0.7%;药敏结果显示,17株CRE菌株对常用抗菌药物高度耐药,除对阿米卡星和头孢哌酮/舒巴坦的耐药率低,分别为35.3%和47.1%,对其他抗菌药物的耐药率在76.4%~100.0%;17株菌均检出blaTEM基因,6株肺炎克雷伯菌同时检出blaSHV基因,并且其中1株肺炎克雷伯菌同时携带blaKPC-2基因,其余基因均阴性;3种整合子中intⅠ基因为阳性,检出率高达70.6%。结论携带blaTEM、blaSHV和blaKPC-2基因是导致该院肠杆菌科细菌对碳青霉烯类抗菌药物耐药的重要原因,Ⅰ类整合子在其耐药基因的转移方面起了十分重要的作用。
[Abstract]:Objective to study the drug resistance mechanism of Enterobacteriaceae, and to provide evidence for rational use of antimicrobial agents in clinic. Methods A total of 2203 strains of Enterobacteriaceae isolates from January to December 2011 were collected and identified by VITEK-2 automatic microbiological analysis system. The improved Hodge method was used to identify the 尾 -lactamase gene and integron gene by the co-assay of EDTA-imipenem and imipenem double-disk synergy method. The products were sequenced by blast software. Results among the 2 203 strains of Enterobacteriaceae, 17 strains were found to have high resistance to common antimicrobial agents, except for amikacin and cefoperazone / sulbactam, and 17 strains were highly resistant to common antimicrobial agents, and the detection rate was 0.70.The results showed that 17 strains of CRE were highly resistant to common antimicrobial agents, except for amikacin and cefoperazone / sulbactam. The resistance rate to other antimicrobial agents was 76.4% and 47.1% respectively. BlaTEM gene was detected in 6 strains of Klebsiella pneumoniae and blaKPC-2 gene was detected in 1 strain of Klebsiella pneumoniae at the same time. All the other genes were negative and the positive rate of int 鈪，

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