肝硬化患者检出产TEM型耐药基因的多重耐药气单胞菌  

Detection of multiresistance Aeromonas with TEM type resistant genes in patients with cirrhosis

作　　者：曲芬[1] 鲍春梅[1] 崔恩博[1] 史佳彬[1] 郭桐生[1] 毛远丽[1] 

机构地区：[1]解放军第三○二医院临床检验中心,北京100039

出　　处：《中华实验和临床病毒学杂志》2005年第1期43-45,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的　研究肝硬化患者感染的多重耐药气单胞菌产 β 内酰酶的情况 ,以指导临床合理用药 ,减少耐药菌产生并控制其传播。方法　 4株多重耐药的气单胞菌分离自解放军第三○二医院的住院重症肝硬化患者 ,TEM耐药基因检测用PCR及琼脂糖凝胶电泳法。结果　 4株多重耐药的气单胞菌为分离自血液及腹水中的温和气单胞菌 1株、嗜水气单胞菌 3株 ,检测TEM阳性的有 3株 ,此3株经测序 ,序列均为TEM-1型。重症肝硬化患者感染多重耐药的气单胞菌可直接影响其预后 ,死亡率达 3 4。结论　我国肝硬化患者感染的多重耐药气单胞菌中检测到TEM 1型 β-内酰酶 ,检出率为3/ 4 ,TEM-1耐药基因是气单胞菌的主要耐药机制 。Objective To study the status of β-lactamase produced by multiresistant Aeromonas selected from cirrhosis patients to provide reference for treatment and reduce resistance and control spreading. Methods Four multiresistant Aeromonas strains isolated from serious liver cirrhosis patients from the No.302 hospital. The TEM resistant genes were detected by PCR and agarose gel electrophoresis. Results Three TEM-1 positive strains were detected from four multiresistant Aeromonas isolates consisting of one Aeromonas sobria and three Aeromonas hydrophila isolated from blood and ascites.This was further confirmed by gene sequencing.The multiresistance to antibiotics was higher in four Aeromonas isolates.All strains tested were resistant to ampicillin,cefazolin and cefmetazole.The cirrhosis patients who suffered from Aeromonas infection had poor prognosis and had mortality rate of 3/4. Conclusion The β-lactamase TEM-1 resistant genes was detected in clinical multiresistant Aeromonas strain isolated from serious cirrhosis patients.The results suggested that TEM-1 was the main resistance mechanism of Aeromonas strain and was reduced by adding enzyme inhibitor.

关 键 词：多重耐药 温和气单胞菌 肝硬化患者 药气 感染 耐药基因 TEM-1型 嗜水气单胞菌 分离 测序 

分 类 号：R575.2[医药卫生—消化系统]