卡他莫拉菌耐药性与β内酰胺酶分型  

Antibacterial agents resistance and typing of β-lactamases in moraxella catarrhalis

作　　者：王艳[1] 张美和[1] 沈叙庄[1] 袁林[1] 杨永弘[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心,100045

出　　处：《中华检验医学杂志》2005年第6期645-647,共3页Chinese Journal of Laboratory Medicine

摘　　要：目的对卡他莫拉菌BROβ内酰胺酶进行分型分析,并对其与抗菌药物耐药的关系进行探讨。方法采用BSAC(britishsocietyforantimicrobialchemotherapy,BSAC)琼脂稀释法对本院呼吸道感染患儿鼻咽部分离的80株卡他莫拉菌株进行8种药敏试验,用Nitrocefin纸片检测β内酰胺酶,采用限制性内切酶分析方法进行bro基因分型,同时将bro1基因阳性和bro2基因阳性菌株对β内酰胺类抗菌药物的耐药性进行比较。结果(1)80株卡他莫拉菌β内酰胺酶阳性率为95.0%。对氨苄西林MIC90为32μg/ml,对头孢呋辛、头孢克洛和头孢噻肟的MIC90分别为4、8、1μg/ml,对四环素的MIC90为16μg/ml;环丙沙星为最敏感的抗菌药。(2)80株卡他莫拉菌bro基因分型结果:6株(7.5%)bro阴性,55株(68.8%)bro1阳性,19株(23.8%)bro2阳性。其中有2株bro基因阴性经Nitrocefin纸片法检测,β内酰胺酶结果为阳性,其他菌株基因检测与产酶结果一致。(3)bro1阳性菌株对氨苄西林、头孢克洛的MIC90值与bro2阳性菌株相比,有不同程度的升高。结论我国儿童携带的卡他莫拉菌产酶率高,对氨苄西林高度耐药。目前应加强该菌对头孢类和四环素的耐药监测。限制性内切酶分析方法在检测bro基因、筛选卡他莫拉菌对β内酰胺类抗生素的耐药及分子流行病学调查方面有一定的应用价值。Objective To distinguish BRO β-lactamase by use of restriction endonuclease analysis and investigate antibacterial agents resistance of Moraxella catarrhalis(M. Catarrhalis) with different BRO β-lactamases .Methods Nasopharyngeal swabs of children with respiratory tract infections from the outpatient department of Beijing Children's Hospital were cultured for isolating M.Catarrhalis. BSAC(british society for antimicrobial chemotherapy) agar diffusion test was used to determine antibacterial agents resistance of M.Catarrhalis.Nitrocefin disk was used to detect β-lactamase. Restriction endonuclease analysis was used to distinguish BRO β-lactamases . Antibacterial agents resistance of M. Catarrhalis with different bro genes was compared.Results (1)95.0% of the 80 strains were beta-lactamase positive. MIC 90 of ampicillin was 32 μg/ml and MIC 90 of cefuroxime,cefaclor and cefotaxime were 4 μg/ml,8μg/ml and 1μg/ml respectively,MIC 90 of tetracycline was 16μg/ml. Among the antibacterial agents,ciprofloxacin was the most sensintive agent.(2)Among 80 strains,6(7.5%) Strains were bro negative,55(68.8%) were bro-1 positive,19(23.8%)were bro-2 positive。Except 2 strains,the results of β-lactamases were same as the results of nitrocefin disk and restriction endonuclease analysis.(3)Compared with bro-2 positive strains,the MIC value of ampicillin and cefaclor for bro-1 positive strains were higher.Conclusions Antibacterial agents resistance of M. Catarrhalis to ampicillin was sierous in China. It should be strengthened to monitor antibacterial agents resistance of M.Catarrhalis. Restriction endonuclease analysis can play an important role on characterizing bro genes,evaluating antibacterial agents resistance of Moraxella Catarrhalis to β-lactam and investigating molecular epideminology

关 键 词：卡他莫拉菌 Β内酰胺酶 耐药性 chemotherapy 限制性内切酶分析 MIC90 Β内酰胺类抗生素 抗菌药物耐药 氨苄西林 分子流行病学 头孢克洛 呼吸道感染 琼脂稀释法 分型分析 药敏试验 基因分型 头孢呋辛 头孢噻肟 环丙沙星 

分 类 号：R446.5[医药卫生—诊断学]