呼吸病房产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性及脉冲场电泳分析

发布时间：2018-01-06 19:16

本文关键词：呼吸病房产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性及脉冲场电泳分析　出处：《实用医学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的对临床分离产超广谱β-内酰胺酶(ESBLs)的肺炎克雷伯菌的耐药性及同源性进行了研究,探讨其流行特点。方法收集2014-2015两年的呼吸病房分离的肺炎克雷伯菌115株,按照NC-CLS/CLSI推荐的确诊试验方法进行产ESBLs的菌株筛选。用纸片扩散(K-B)法,用常见的26种抗生素纸片对分离的产ESBLs的肺炎克雷伯菌进行药敏检测(操作及结果判断参照NCCLS/CLSI2015年标准)。采用凝胶脉冲场电泳(pulsed-field gel electrophoresis,PFGE)对产ESBLs菌株进行染色体DNA分型。结果115株肺炎克雷伯菌产ESBLs60株,药敏结果产ESBLs 60株菌对亚胺培南,美罗培南敏感率为100%;对氨曲南,氨苄西林,哌拉西林及一到四代头孢菌素类基本均耐药。PFGE将产ESBLs肺炎克雷伯菌基因分14个型(A~N),其中A型为流行菌株(35%,21/60)。结论在呼吸病房中产ESBLs的肺炎克雷伯菌比例较大,耐药性严重,并存在着同源性的肺炎克雷伯菌株的流行,应给予足够的重视。PFGE是一种稳定、精确的基因分型方法,适合用作院内感染的同源性分析。
[Abstract]:Objective to study the drug resistance and homology of Klebsiella pneumoniae isolated from extended-spectrum 尾 -lactamases (ESBLs). Methods 115 strains of Klebsiella pneumoniae isolated from respiratory wards in 2014-2015 were collected. The strains producing ESBLs were screened according to the diagnostic test recommended by NC-CLS/CLSI. Antimicrobial susceptibility of isolated Klebsiella pneumoniae producing ESBLs was detected with 26 kinds of antibiotic sheets (operation and result judging with reference to NCCLS/CLSI2015 year standard). Pulsed-field gel electrophoresis was used. Results 115 strains of Klebsiella pneumoniae produced ESBLs60 strains, and the drug sensitive strains produced ESBLs60 strains to imipenem. The sensitivity rate of meropenem was 100. To aztreonam, ampicillin, piperacillin and cephalosporins of one or four generations, the gene of Klebsiella pneumoniae was divided into 14 types. Conclusion the proportion of Klebsiella pneumoniae producing ESBLs in respiratory ward is large and the drug resistance is serious. Due to the prevalence of homologous Klebsiella pneumoniae, PFGE is a stable and accurate genotyping method, which is suitable for homology analysis of nosocomial infection.
【作者单位】：黑龙江省齐齐哈尔市第一医院检验科;
【基金】：齐齐哈尔市科学技术计划项目(编号:SFGG-201351)
【分类号】：R446.5
【正文快照】： 肺炎克雷伯菌(KPN)是院内感染最常见的致病菌之一[1],特别是近年来新型抗生物素的不合理使用,多重耐药菌株快速上升的趋势给临床抗感染治疗带来极大困难[2]。产ESBLs菌株的流行机制比较复杂,可能存在流行菌株的扩散及质粒或耐药基因的转移。脉冲场电泳(PFGE)是对细菌DNA限制性

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