阴沟肠杆菌超广谱β-内酰胺酶、AmpC酶基因检测及耐药性分析  

Detection and analysis of the resistance and prevalence of extended-spectrum β-lactamases and AmpC-encoding genes in Enterobacter cloacae

作　　者：周铁丽[1] 郑佳音[1] 李超[1] 黄海霞[1] 

机构地区：[1]温州医学院附属第一医院,温州325000

出　　处：《中国抗生素杂志》2006年第10期615-619,共5页Chinese Journal of Antibiotics

摘　　要：目的了解阴沟肠杆菌超广谱β-内酰胺酶(ESBLs)和AmpC酶的产生情况,研究β-内酰胺酶的基因型别,并分析产酶特性和耐药表型的相关性。方法用酶提取三维试验检测ESBLs和AmpC酶,聚合酶链反应(PCR)扩增β-内酰胺酶的基因;VITEK全自动药敏分析系统和KB法检测细菌耐药性。结果101株阴沟肠杆菌中,检出ESBLs阳性株39株,高产AmpC酶阳性株53株,其中16株ESBLs和AmpC酶均阳性,非产酶菌25株;12株AmpC酶阳性菌中,7株扩增出blaDHA基因,8株扩增出blaMIR基因,其中5株同时携带blaDHA和blaMIR基因,1株同时携带blaMIR和blaFOX基因,4株三维试验阴性菌株blaMIR基因阳性;16株ESBLs阳性菌中,8株扩增出blaTEM基因,2株ESBLs三维试验阴性菌株blaTEM基因阳性,未检出blaSHV基因。阴沟肠杆菌对多种抗生素高度耐药,产酶菌株的耐药性明显高于非产酶株。结论阴沟肠杆菌中ESBLs和AmpC酶检出率均很高,AmpC酶以blaDHA、blaMIR基因型为主。产ESBLs和AmpC酶是阴沟肠杆菌耐药的主要原因。Objective To investigate the prevalence of extended-spectrum β-lactamase and AmpC β-lactamase in Enterobacter cloacae, study the genotyping of β-lactamase, and analyze its independence in drug resistance. Method Three dimensional test was used to detect ESBLs and AmpC; PCR was used to determine the genotype of β-lactamase; antimicrobial susceptibility were tested by Vitek-AMS and Kirby-Bauer method. Results Of the 101 Enterobacter cloacae strains, ESBLs were detected in 39 strains; AmpC in 53 strains; ESBLs and AmpC were simultaneously detected in 16 strains. Of the 12 AmpC-positive stains, blaDHA existed in 7 strains; blaMeR in 8 strains; blaDHA and blaMeR simultaneously occurred in 5 strains; blaMeR and blaFOX simultaneously occurred in 1 strains; 4 strains had blaMIR gene but AmpC three dimensional test negative. Of the 16 ESBLs-positive stains, blaTEM was detected in 8 strains, 2 strains had blaTEM gene but were negative in ESBLs three dimensional test. Enterobacter cloacae were multidrug resistant, enzyme positive strains were more resistant to antibiotics than negative ones. Conclusion ESBLs and AmpC in Enterobacter cloacae were severe and prevalent, blaDHA and blaMeR were main genotyping of AmpC. Producing ESBLs and AmpC enzyme was prominently cause of resistant in Enterobacter cloacae.

关 键 词：阴沟肠杆菌 超广谱Β-内酰胺酶 AMPC酶 基因型 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]