耐碳青霉烯类抗菌药物的肠杆菌科细菌耐药性与分子特征分析

发布时间：2018-05-30 16:56

本文选题：碳青霉烯酶 + 肠杆菌科细菌　；参考：《中华医院感染学杂志》2017年08期

【摘要】：目的了解对碳青霉烯类抗菌药物不敏感的肠杆菌科细菌的发生及耐药情况,探讨耐药与产酶的关系。方法选取2011-2012年医院亚胺培南或美罗培南不敏感的肠杆菌科细菌15株,用琼脂稀释法测定最小抑菌浓度(MIC),改良Hodge试验和EDTA纸片协同试验筛选产碳青霉烯酶表型;PCR检测碳青霉烯酶基因及其他β-内酰胺酶基因,多位点序列分型(MLST)进行分子分型及同源分析。结果共收集碳青霉烯类抗菌药物不敏感肠杆菌科细菌15株;多黏菌素B和替加环素敏感性较高,均90.00%;肺炎克雷伯菌、大肠埃希菌和黏质沙雷菌均检出产KPC酶菌株,占73.33%;11株产KPC酶菌中10株为KPC-2+ESBLs,1株为KPC-2+AmpC,其中3株为KPC-2+ESBLs+AmpC,4株非产KPC酶菌株中有2株ESBLs+AmpC,各有1株仅检测到ESBLs或AmpC酶,未检测到产金属酶及OXA酶菌株;MLST分型以ST11为主,共4株。结论医院产KPC-2酶细菌以肺炎克雷伯菌最多,产KPC菌株同时携带多种耐药基因与高度耐药相关;ST11型为医院优势流行型别。
[Abstract]:Objective to understand the occurrence and drug resistance of Enterobacteriaceae, which are insensitive to carbapenems, and to explore the relationship between resistance and enzyme production. Methods 15 strains of Enterobacteriaceae which were insensitive to imipenem or meropenem in 2011-2012 years were selected. The minimum inhibitory concentration (MIC), improved Hodge test and EDTA paper were measured by agar dilution method. Carbon penicillenase phenotypes were screened by a synergistic test; PCR was used to detect carbapenem gene and other beta lactamase genes and multiple point sequence typing (MLST) for molecular typing and homology analysis. The results showed that 15 strains of carbapenem antibiotics were not sensitive to Enterobacteriaceae, and polymyxin B and tigocycline were more sensitive and 90%. KPC enzyme producing strains were detected by Klebsiella, Escherichia coli and salebella mucinus, accounting for 73.33%; 10 of KPC strains were KPC-2+ESBLs, 1 were KPC-2+AmpC, 3 of them were KPC-2+ESBLs+AmpC, 2 of 4 non producing KPC strains were ESBLs+AmpC, and 1 strains detected only ESBLs or AmpC enzyme, and no metalloenzyme and OXA enzyme strains were detected; MLST was not detected; MLST A total of 4 strains were classified as ST11. Conclusion the most KPC-2 bacteria produced in hospital were Klebsiella pneumoniae, and KPC producing strains were associated with multidrug resistance genes and high drug resistance, and type ST11 was the dominant epidemic type in hospital.
【作者单位】：解放军总医院第一附属医院感染控制科;
【分类号】：R446.5;R440

【相似文献】