阴沟肠杆菌对β内酰胺类和氨基糖苷类抗生素的耐药性及其耐药基因  

Drug resistance of Enterobacter cloacae to β-lactamas and aminoglycosides and its genotypes

作　　者：蔡培泉[1] 王春新[1] 黄支密[2] 

机构地区：[1]南京医科大学附属无锡第一医院,江苏无锡214002 [2]中国人民解放军98医院,浙江湖州313000

出　　处：《现代实用医学》2006年第3期152-153,186,共3页Modern Practical Medicine

摘　　要：目的 调查临床分离的阴沟肠杆菌对β内酰胺类和氨基糖苷类抗生索的耐药性及其耐药基因。方法 采用ATB药敏试验板微量肉汤法，对20株临床分离的阴沟肠杆菌进行抗生素敏感试验，PCR方法检测TEM、SHV、CTX-M、OXA-1群、PER、VEB、GES、DHA、MIR等9种BLAs基因与aac（3）-Ⅰ、aac（3）-Ⅱ、aac（6′）-Ⅰ、aac（6′）-Ⅱ、ant（3″）-Ⅰ，ant（2″）-Ⅰ等6种AMEs基因。结果 该20株菌对亚胺培南和美罗培南均敏感，对其他抗生素的耐药率在50．0％～85．0％之间。MIR、DHA和TEM基因的阳性率分别为70.0％、45．0％和55．0％。而其余BIAs基因均阴性。19株（95．0％）检出氨基糖苷类修饰酶基因：ant（6′）-Ⅰ、ant（3″）-Ⅰ、ant（2″）-Ⅰ、ant（6′）-Ⅱ、aac（3）-Ⅱ基因的阳性率分别为50．0％、15．0％、10．0％、5．0％、5．0％，而anc（3），Ⅰ基因均阴性。结论 临床分离的阴沟肠杆菌多重耐药严重，其8内酰胺酶基因和氨基糖苷类修饰酶基因携带率高。Objective To investigate the drug resistance of Enterobacter cloacae isolated from clinical samples to β-lactamas and aminoglycosides and its genotypes. Methods Antimicrobial susceptibility test were performed by microdiluted method, BLAs and AMEs genes were detected by PCR method for 20 strains of Enterobacter cloacae isolated from clinical samples. Results All strains were susceptible to imipenem and meropenem, the resistant rates to other antimicrobial agents of them were between 50.0% and 85.0%. The positive rate of MIR,DHA and TEM genes was 70.0% ,45.0% and 55.0%, respectively. But other BLAs gene was not found. AMEs genes were found in 19 strains（95.0% ）. The positive rate of aac （6′ }-Ⅰ ,ant（3″）-Ⅰ ,ant（2＂）-Ⅰ , aac （6′）-Ⅰ, aac （ 3）-Ⅱgenes was 50.0%, 15.0%, 10.0%, 5.0% and 5.0%, respectively. But the aae （ 3 ）-Ⅰ gene was not found. Condusion There ate multiple-drug resistance and high positive rate of BLAs and AMEs genes in Enterobacter cloacae isolated from clinical samples.

关 键 词：抗药性 多药 基因型 Β内酰胺类 氨基糖苷类 阴沟肠杆菌 抗生素 

分 类 号：R978.1[医药卫生—药品]