23株耐碳青霉烯类肠杆菌科细菌耐药基因分析

发布时间：2018-11-05 21:03

【摘要】：目的分析耐碳青霉烯类肠杆菌科细菌(CRE)的耐药情况及其耐药基因,为临床防治CRE感染提供依据。方法收集23株CRE,采用全自动微生物分析系统行菌株鉴定和药敏试验,采用改良Hodge试验检测碳青霉烯酶表型,PCR扩增和基因测序技术检测其耐药相关基因(包括bla KPC、bla NDM、bla OXA、bla VIM、bla IMP)及分布。结果 23株CRE中,肺炎克雷伯菌11株,大肠埃希菌7株,阴沟肠杆菌2株,产酸克雷伯杆菌2株,枸橼酸杆菌1株。药敏试验结果显示,对碳青霉烯类抗生素亚胺培南的耐药率为95.65%,对美罗培南的耐药率为86.95%;23株菌株均对哌拉西林、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药,耐药率为100%;对阿米卡星的耐药率为65.21%,对环丙沙星的耐药率为86.96%,对氨曲南的耐药率为91.30%。改良Hodge试验阳性16株、阴性7株。PCR法检出bla KPC型基因6株、bla NDM型基因6株、bla OXA型基因9株、bla VIM型基因2株,未检出bla IMP型基因。结论 23株CRE对多种抗生素耐药率均较高,其主要耐药基因型为OXA、KPC、NDM、VIM型碳青霉烯酶基因。
[Abstract]:Objective to analyze the drug resistance of Enterobacteriaceae (CRE) and its resistance genes to provide evidence for clinical prevention and treatment of CRE infection. Methods 23 strains of CRE, were collected for identification and drug sensitivity test by automatic microbiological analysis system, carbapenem phenotype was detected by modified Hodge test, and its drug-resistance related genes (including bla KPC,bla NDM,) were detected by PCR amplification and gene sequencing. Bla OXA,bla VIM,bla IMP) and its distribution. Results among 23 strains of CRE, 11 strains were Klebsiella pneumoniae, 7 strains were Escherichia coli, 2 strains were Enterobacter cloacae, 2 strains were Klebsiella pneumoniae and 1 strain was Citrobacter. The results of drug sensitivity test showed that the resistance rate of imipenem to carbapenem was 95.65 and that to meropenem was 86.95. All 23 strains were resistant to piperacillin, piperacillin / tazobactam, cefoperazone / sulbactam, and the resistance rate was 100. The resistance rate to amikacin, ciprofloxacin and aztreonam was 65.21, 86.96 and 91.3030, respectively. Bla KPC type gene 6 strains, bla NDM type gene 6 strains, bla OXA type gene 9 strains, bla VIM type gene 2 strains were detected by modified Hodge test. Bla IMP type gene was not detected by PCR method. Conclusion the resistant rate of 23 strains of CRE to various antibiotics was high, and the main genotypes were OXA,KPC,NDM,VIM type carbapenem gene.
【作者单位】：天津市第一中心医院;天津医科大学;
【基金】：国家临床重点专科建设项目(2013-544)
【分类号】：R446.5

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