碳青霉烯类耐药肠杆菌科细菌碳青霉烯及头孢菌素类抗生素耐药机制

发布时间：2018-05-01 11:15

本文选题：碳青霉烯类耐药 + 肠杆菌科细菌　；参考：《中国感染控制杂志》2017年05期

【摘要】：目的研究碳青霉烯类耐药肠杆菌科细菌(CRE)对碳青霉烯及头孢菌素类抗生素耐药机制,为临床治疗CRE感染及医院感染的控制提供分子流行病学依据。方法收集2014—2015年临床送检各类标本分离的细菌,使用Microscan Walkaway 40 plus进行细菌鉴定和药敏试验,对分离的CRE进行常见碳青霉烯酶的编码基因(bla_(NDM-1)及bla_(KPC-2))和超广谱β-内酰胺酶编码基因(bla_(TEM)、bla_(SHV)、bla_(CTX-M-1)-like、bla_(CTX-M-2)-like、bla_(CTX-M-8)-like及bla_(CTX-M-9)-like)的检测,同时检测细菌多重耐药相关的Ⅰ类整合子编码基因bla_(inT-1)。结果 2014—2015年共分离7株CRE,检出率为0.30%,1~6号菌株为肺炎克雷伯菌,7号菌株为弗劳地柠檬酸杆菌,7株菌株对β-内酰胺酶抑制剂复合制剂、头孢菌素类、头霉素类、碳青霉烯类抗生素均耐药,3株菌对阿米卡星及四环素敏感,2株菌对复方磺胺甲口恶唑敏感。3株菌检出bla_(NDM-1),2株检出bla_(KPC-2),5株检出bla_(TEM),7株均可检出bla_(SHV),1株检出bla_(CTX-M-1)-like,4株检出bla_(CTX-M-9)-like,5株检出bla_(inT-1),未检出基因bla_(CTX-M-2)-like及bla_(CTX-M-8)-like。结论 bla_(NDM-1)及bla_(KPC-2)是导致7株CRE对碳青霉烯类抗生素耐药的重要机制,bla_(TEM)、bla_(SHV)及bla_(CTX-M-9)-like是导致对头孢菌素类抗生素耐药的主要原因,bla_(inT-1)在CRE多重耐药及耐药基因传播中发挥着巨大的作用。
[Abstract]:Objective to study the mechanism of carbapenem resistance to carbapenem and cephalosporins and to provide molecular epidemiological evidence for the control of CRE infection and nosocomial infection. Methods the bacteria isolated from various clinical specimens were collected from 2014 to 2015. Microscan Walkaway 40 plus was used for bacterial identification and drug sensitivity test. The common CRE encoding genes (NDM-1) and KPC-2G) and extended-spectrum 尾 -lactamase (ESBL) were detected by the method of detection of CTX-M-2- like and CTX-M-9like-like CRE, and the class I integron coding gene blain-1 related to bacterial multidrug resistance was detected by means of the detection of CTX-M-2- like blaster-like blastoxapenase (CTX-M-8-like) and blastatin (KPC-2G) and extended-spectrum 尾 -lactamase (ESBL) coding gene, and the class I integron coding gene blaint-1a related to bacterial multidrug resistance was also detected by detection of CTX-M-2- like-like blastatin gene (CTX-M-2- like), CTX-M-2- like, CTX-M-9like-like). Results A total of 7 strains of Cree were isolated in 2014-2015. The positive rate was 0.30 ~ 1 ~ 6 strains of Klebsiella pneumoniae, 7 strains of Citric acid bacillus forlaudi and 7 strains of 尾 -lactamase inhibitor compound preparation, cephalosporins, cephalomycin, cephalosporins, cephalosporins and cephalomycin. Three strains of carbapenem antibiotics were resistant to amikacin and 2 strains of tetracycline were sensitive to compound sulfamethoxazole. 3 strains were found to be sensitive to compound sulfamethoxazole. 2 strains were detected from NDM-1 strain. 5 strains of Tem were detected from 5 strains of KPC-2P. The gene bla_(CTX-M-2)-like and blagas CTX-M-8 like were not detected. Conclusion\)\?
【作者单位】：南方医科大学第三附属医院;南方医科大学检验系;
【分类号】：R446.5

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