部分发酵类肠杆菌科细菌耐药性及耐碳青霉烯类基因检测分析

发布时间：2018-01-31 09:30

  本文关键词： 肠杆菌科细菌 碳青霉烯类 NDM- 耐药性　出处：《中国病原生物学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的检测部分发酵类肠杆菌科细菌对临床推荐用抗生素的敏感性并筛查耐碳青霉烯类基因。方法采集鄂西北地区2013年1-12月间住院病人的血、痰、中段尿、前列腺液、分泌物或引流液等,常规琼脂培养法分离发酵类肠杆菌肺炎克雷伯菌(Klebsiella pneumoniae)、产酸克雷伯菌(Klebsiella oxytoca)、大肠埃希菌(Escherichia coli)、阴沟肠杆菌(Enterbacter cloacae)及沙雷氏菌(Serratia);利用Vitek-2分析系统鉴定菌株并检测其耐药性;PCR法扩增抗碳青霉烯类(亚胺培南和/或美罗培南)菌株耐药基因。结果共获得2 291株肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌和沙雷氏菌等分离株,产ESBLs率分别为47.4%、62.6%、9.1%、22.6%;临床推荐用抗生素耐药率:头孢唑啉(Ⅰ)分别为45.4%、73.7%、93.3%、100%,头孢西丁(Ⅱ)分别为17.3%、15.2%、84.9%、33.3%,头孢曲松(Ⅲ)分别为48.4%、65.0%、43.8%、44.4%;阿米卡星分别为17.4%、10.4%、28.1%、24.4%,氨曲南分别为35.4%、38.9%、49.1%、38.9%,亚胺培南(分别为1.8%、1.8%、17.6%、2.4%,美罗培南分别为1.1%、0.8%、6.7%、20%。其中分离出46株耐亚胺培南和/或美罗培南菌株,肺炎克雷伯菌P2964和肺炎克雷伯菌B195携带blaKPC-2基因,肺炎克雷伯菌P6558和产酸克雷伯菌B1645-1携带blaNDM-1基因。结论鄂西北地区部分发酵类肠杆菌耐药率呈上升趋势并出现耐碳青霉稀类菌株,菌株间可能存在耐药基因的传递并有造成感染扩散的风险,尤其在住院病人之间,应予以高度重视。
[Abstract]:Objective to detect the sensitivity of some enterobacteriaceae fermentative bacteria to clinical recommended antibiotics and to screen carbapenem resistant genes. Methods Blood and sputum were collected from hospitalized patients in Northwest Hubei from 2013 to December. Median urine, prostatic fluid, secretion or drainage fluid were isolated from Klebsiella pneumoniae by routine Agar culture. Klebsiella oxytocai, Escherichia coli. Enterbacter cloacaeae and Serratia Shareh; The strains were identified by Vitek-2 analysis system and their drug resistance was detected. The resistant genes of carbapenem resistant strains (imipenem and / or meropenem) were amplified by PCR. A total of 2 291 strains of Klebsiella pneumoniae and Escherichia coli were obtained. The ESBLs production rates of Enterobacter cloacae and Shareh's bacteria were 47.4 and 62.6, respectively. The rate of antibiotic resistance recommended for clinical use: cefazolin (鈪，

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