碳青霉烯类耐药阴沟肠杆菌耐药机制研究

发布时间：2019-03-03 11:23

【摘要】：目的研究碳青霉烯类耐药阴沟肠杆菌的耐药机制。方法收集福建医科大学附属协和医院2011年8月-2012年8月的碳青霉烯类耐药阴沟肠杆菌,采用琼脂稀释法进行药敏试验;改良Hodge试验筛查菌株是否产碳青霉烯酶;利用PCR扩增碳青霉烯酶基因(KPC、IMP、VIM、NDM)及其他β内酰胺酶基因(SHV、TEM、CTX-M-1组、CTX-M-2组、CTX-M-9组);利用肠杆菌基因重复一致序列分析(ERIC-PCR)进行菌株同源性分析;通过接合试验验证碳青霉烯酶基因是否能水平转移。结果共收集29株阴沟肠杆菌,药敏结果显示对检测抗菌药物耐药率90%的有3种,分别为头孢他啶(93.1%)、头孢西丁(100%)和氨曲南(93.1%);多黏菌素B耐药率最低为3.4%。改良Hodge试验阳性率为79.3%(23/29)。29株实验菌共检出23株含有β内酰胺酶基因,其中IMP基因阳性17株、KPC基因阳性1株。29株阴沟肠杆菌可分为23个不同的型别,其中1株未能分型。接合试验成功率48.3%(14/29)。结论该院碳青霉烯类耐药阴沟肠杆菌携带碳青霉烯酶基因,以IMP基因较常见。
[Abstract]:Objective to study the drug resistance mechanism of carbapenem resistant Enterobacter cloacae (Enterobacter cloacae). Methods Enterobacter cloacae resistant to carbapenem was collected from Union Hospital affiliated to Fujian Medical University from August 2011 to August 2012 and the susceptibility test was carried out by Agar dilution method and the strains were screened for carbapenase production by modified Hodge test. The carbapenase gene (KPC,IMP,VIM,NDM) and other 尾 lactamase genes (SHV,TEM,CTX-M-1, CTX-M-2, CTX-M- 9) were amplified by PCR. The homology analysis of Enterobacter spp. Gene repeat consistent sequence analysis (ERIC-PCR) was carried out, and the horizontal transfer of carbapenase gene was verified by conjugation test. Results A total of 29 strains of Enterobacter cloacae were collected. The results of drug sensitivity showed that three strains were ceftazidime (93.1%), cefoxitin (100%) and aztreonam (93.1%). The lowest drug resistance rate of polymyxin B was 3.4%. The positive rate of modified Hodge test was 79.3% (23 / 29). A total of 23 strains with 尾-lactamase gene were detected in 29 strains, of which 17 strains were positive for IMP gene and 1 strain was positive for KPC gene, and 29 strains of Enterobacter cloacae could be divided into 23 different types. One of them could not be typed. The success rate of joint test was 48.3% (14 / 29). Conclusion Enterobacter cloacae resistant to carbapenem carries carbapenase gene, especially IMP gene.
【作者单位】：福建医科大学附属协和医院检验科;福建医科大学协和临床医学院;
【基金】：国家自然科学基金(81201328,81171656) 福建省高校杰青项目(JA13134) 福建省卫计委中青年骨干人才培养项目(2015-ZQN-ZD-15)
【分类号】：R446.5;R440

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