肺炎克雷伯杆菌对头孢菌素类抗生素耐药机制的研究

发布时间：2018-04-13 23:27

本文选题：肺炎克雷伯杆菌 + 头孢菌素类抗生素　；参考：《四川大学》2006年硕士论文

【摘要】：头孢菌素类抗生素曾广泛用于肺炎克雷伯杆菌所致感染，其作用机制主要是作用于青霉素结合蛋白(penicillin-binding proteins，PBPs)，抑制细菌细胞壁的合成，菌体失去渗透屏障而膨胀、裂解，同时借助细菌的自溶酶(autolysins)溶解而产生抗菌作用。但随着药物在临床的广泛使用，耐药菌株愈来愈多见，，导致临床对该菌所致感染治疗困难甚至失败。因此研究其耐药机制对临床有效治疗肺炎克雷伯杆菌引起的感染和开发新的头孢菌素类药物有重要的指导意义。目的：研究四川大学华西医院自2003年9月～2004年3月间分离的18株肺炎克雷伯杆菌对头孢菌素类抗生素的耐药性及其机制，以了解当前耐药性状况，为临床合理使用抗生素提供参考。方法：收集、分离及鉴定肺炎克雷伯杆菌，用琼脂二倍稀释法及纸片扩散法测定临床分离肺炎克雷伯杆菌对8种抗菌药物的MIC值，以标准敏感菌株ATCC25922作为质控菌株；Nitrocefine法定性筛选细菌的β-内酰胺酶；通过NCCLS 2004版推荐的纸片扩散法初筛超广谱β-内酰胺酶(ESBLs)；酶提取物三维试验和加抑制剂酶提取物三维试验检测高产AmpC酶的肺炎克雷伯杆菌；采用聚合酶链反应(PCR)扩增bla_(TEM)、
[Abstract]:Cephalosporins have been widely used in Klebsiella pneumoniae infection, and the mechanism of their action is to inhibit the synthesis of bacterial cell wall, and the bacteria lose the osmotic barrier and expand and lyse, which is mainly caused by penicillin binding protein penicillin-binding protein (PBPsN).At the same time, the bacteria were dissolved by autolysins to produce antimicrobial effect.However, with the wide use of drugs in the clinic, drug resistant strains are becoming more and more common, which leads to the difficulty or even failure of clinical treatment of the infection caused by this bacterium.Therefore, it is important to study the mechanism of drug resistance in the clinical treatment of Klebsiella pneumoniae infection and the development of new cephalosporins.Objective: to study the resistance of 18 strains of Klebsiella pneumoniae isolated from September 2003 to March 2004 in Huaxi Hospital of Sichuan University to cephalosporin antibiotics and to understand the current drug resistance.To provide reference for rational use of antibiotics in clinic.Methods: Klebsiella pneumoniae was collected, isolated and identified. The MIC values of clinical isolates of Klebsiella pneumoniae against 8 antimicrobial agents were determined by Agar double dilution method and disk diffusion method.尾 -lactamases of bacteria were qualitatively screened by nitrocefine assay using standard sensitive strain ATCC25922 as quality control strain.Extended-spectrum 尾 -lactamase (ESBLsN) was screened by disk diffusion method recommended by NCCLS 2004, enzyme extract three-dimensional test and inhibitor enzyme extract three-dimensional test were used to detect Klebsiella pneumoniae with high AmpC enzyme production.
【学位授予单位】：四川大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R378

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