耐头孢哌酮对头孢哌酮/舒巴坦敏感的革兰阴性杆菌β-内酰胺酶分析  

Analysis of β-lactamases from Gram-negative bacteria resistant to cefoperazone,susceptible to sulbactam/cefoperazone

作　　者：孙广英[1,2] 孙百亮 张永龙[4] 孙紫英 孙鑫 罗萍 李家泰[4] 

机构地区：[1]华中科技大学同济医学院基础医学院 [2]湖北省广水市十里医院,广水432700 [3]湖北省广水市十里医院 [4]北京大学第一医院临床药理研究所 [5]湖北省咸宁市第一人民医院

出　　处：《中国抗生素杂志》2006年第10期604-608,共5页Chinese Journal of Antibiotics

摘　　要：目的分析对头孢哌酮耐药但对头孢哌酮/舒巴坦敏感的革兰阴性杆菌β-内酰胺酶。方法用PCR方法扩增62株临床分离菌TEM型及SHV型β-内酰胺酶耐药基因并对从65株临床分离的革兰阴性杆菌及7株铜绿假单胞菌中分离提取的β-内酰胺酶进行等电点测定。结果62株临床分离菌PCR扩增结果表明,58.1%(36/62)对头孢哌酮耐药但对头孢哌酮/舒巴坦敏感的革兰阴性杆菌含有TEM型β-内酰胺酶;32.3%(20/62)含有SHV型β-内酰胺酶。65株临床分离的革兰阴性杆菌产生的β-内酰胺酶等电点的测定结果表明36.9%(24/65)的革兰阴性杆菌产生一种β-内酰胺酶,29.2%的革兰阴性杆菌产生2种β-内酰胺酶,13.8%的革兰阴性杆菌产生3种β-内酰胺酶,10.7%的革兰阴性杆菌产生4种β-内酰胺酶,6.1%的革兰阴性杆菌产生5种β-内酰胺酶。6株铜绿假单胞菌产生1种β-内酰胺酶,1株铜绿假单胞菌产生2种β-内酰胺酶。β-内酰胺酶的等电点介于4.95～9.36之间。72株临床分离菌共产生160种β-内酰胺酶。全部β-内酰胺酶能够水解头孢哌酮,而舒巴坦可以抑制酶的活性。β-内酰胺酶对头孢哌酮/舒巴坦(1∶1)的水解率与头孢他啶相似,但低于对阿莫西林/克拉维酸(1∶5)和哌啦西林/三唑巴坦(1∶8)的水解率。包括7株铜绿假单胞菌在内的72株产生β-内酰胺酶的革兰阴性杆菌对头孢哌酮/舒巴坦敏感。结论大部分对头孢哌酮耐药但对头孢哌酮/舒巴坦敏感的革兰阴性杆菌产生TEM型β-内酰胺酶,舒巴坦可以增强头孢哌酮对包括铜绿假单胞菌在内的产酶革兰阴性杆菌的抗菌活性。Objective To analyze β-lactamases from Gram-negative bacteria which were resistant to cefoperazone and susceptible to sulbactam/cefoperazone. Methods PCR amplification of blaTEM and blaSHV gene from 62 strains of Gram-negative bacteria and the detection of isoelectric point of β-lactamases extraction from 65 strains of Gram-negative bacillis and 7 strains of Pseudomones aeruginosa were performed. Results 58.1% （36/62） of Gramnegative bacteria resistant to cefoperazone, susceptible to sulbactam/cefoperazone carried blaTEM gene. 32.3% （20/ 62） of them contained blaSHW gene. The results of isoelectric point detection showed that 36.9% （24/65） of Gramnegative bacteria produced one β-lactamases; 29.2% of them produced two β-lactamases; 13.8% of them produced three β-lactamases; 10.7% of them produced four β-lactamases and 6.1% of them produced five β-lactamases. Sixstrains of Pseudomones aeruginosa produced one β-lactamases and one strain of P. aeruginosa produced two β-lactamases. The pI value of these enzymes were between 4.95 and 9.36. Seventy-two isolates produced total about 160 β-lactamases. All these enzymes could hydrolyze cefoperazone and be inhibited by sulbactam. The hydrolysis rates of sulbactam/cefoperazone （1： 1 ） were near to that of ceftazidime, lower than that of clavulanate/amoxicillin （1 ： 5） and tazobactam/piperacillin （ 1 ： 8）. Seventy-two strains of Gramegative bacteria including 7 strains of P. aeruginosa which produced β-lactamases were susceptible to sulbactam/cefoperazone. Conclusion Most of Gram-negative bacteria resistant to cefoperazone, susceptible to sulbactam/cefoperazone produced TEM-type β-lactamases. The activity of cefoperalone against Gram-negative bacilli producing β-lactamases including P. aeruginosa could be enhanced by sulbactam.

关 键 词：头孢哌酮 舒巴坦 革兰阴性杆菌 Β-内酰胺酶 

分 类 号：R378[医药卫生—病原生物学]