大肠埃希菌、肺炎克雷伯菌质粒β-内酰胺酶检测  

Detection of Plasmid Mediated Beta-lactamases in Escherichia coli and Klebsiella pneumoniae Isolates

作　　者：章清[1] 魏丽[1] 魏光美[1] 苗群[1] 

机构地区：[1]复旦大学附属上海市第五人民医院,上海200240

出　　处：《中华医院感染学杂志》2004年第3期328-330,共3页Chinese Journal of Nosocomiology

摘　　要：目的　了解大肠埃希菌和肺炎克雷伯菌产质粒β-内酰胺酶的类型、检测方法及耐药性。方法　用 NCCL S确证试验检测超广谱β-内酰胺酶 ,根据表型、纸片协同试验及头孢西丁三相试验检测 Amp C酶。结果　 835株大肠埃希菌和肺炎克雷伯菌 ,共检测出产超广谱β-内酰胺酶菌株 2 2 0株 ,大肠埃希菌和肺炎克雷伯菌总 ESBL s发生率为 2 6 % ;根据头孢西丁三相试验结果 ,表现为产 Amp C酶的菌株共有 36株 ,检出率为 4 .31% ,表型鉴别高产Amp C酶 ,表现为产 Amp C酶的菌株共有 37株 ,检出率为 4 .4 3% ,与头孢西丁三相试验符合率为 97.3% ;纸片协同试验表现为产 Am p C酶的为 32株 ,检出率为 3.83% ,与头孢西丁三相试验符合率为 88.9%。结论　大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶为主 ;表型筛选法检测 Am p C酶结果可靠、方法简便 ,易于在临床实验室中推广应用。OBJECTIVE To determine plasmid mediated beta-lactamase in Escherichia coli and Klebsiella pneumoniae isolates, and to evaluate relative detection methods. METHODS Extended broad spectrum beta-lactamases were determined by using confirmatory test recommended by NCCLS. AmpC enzymes were detected with phenotype observation, sheet paper cooperation test and cefoxitin triphase assay. RESULTS The presence of extended spectrum beta-lactamases (ESBLs) in 835 E.coli and 128 K.pneumoniae strains was determined. ESBLs were detected in 220 strains (26%). AmpC beta-lactamases were detected in 36(4.31%) strains by cefoxitin triphase test, 37(4.43%) strains by no phenotypic test, 32 (3.83%)strains by sheet paper cooperation test. The results of phenotypic test and sheet paper cooperation test were similar to those of cefoxitin triphase test. The coincidence rate was 97.3% and 88.9%, respectively. CONCLUSIONS The mainly beta-lactamases produced by E. coli and K. pneumoniae were ESBLs. The phenotypic screening methods for the detection of AmpC enzyme were simple, reliable and could be used in clinical laboratory.

关 键 词：超广谱Β-内酰胺酶 质粒AMPC酶 大肠埃希菌 肺炎克雷伯菌 

分 类 号：R378.2[医药卫生—病原生物学]