产超广谱β-内酰胺酶肺炎克雷伯菌CTX-M基因型和耐药性分析  

CTX-M gene typing and antibiotic resistance against β-lactams in ESBL-producing Klebsiella pneumoniae

作　　者：付英梅[1,2] 张文莉[1,2] 许建丰[1,2] 陈小贝[1,2] 崔洪波[1,2] 张凤民[1,2] 

机构地区：[1]哈尔滨医科大学微生物学教研室 [2]黑龙江省高校重点实验室,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2006年第6期433-437,共5页Journal of Harbin Medical University

基　　金：国家十五科技攻关项目(2004BA720A09-02);黑龙江省教育厅资助项目(11511207)

摘　　要：目的研究哈尔滨市肺炎克雷伯菌中CTX-M型超广谱β-内酰胺酶(ESBLs)的流行组别和细菌耐药性特征。方法收集哈尔滨市4所医院非重复的74株产ESBLs肺炎克雷伯菌,采用CTX-M1、2、8、9组特异性PCR引物检测菌株质粒上相应4组CTX-M基因的存在情况,并用K-B纸片扩散法测定菌株对临床相关的广谱β-内酰胺类抗菌药物的耐药性。结果产ESBLs肺炎克雷伯菌中25.7%的菌株CTX-M1组PCR扩增阳性,39.2%为CTX-M9组阳性,未检测到CTX-M2组和CTX-M8组的存在。CTX-M阳性株对头孢噻肟、头孢曲松和头孢他啶的耐药率与CTX-M阴性株相比,差异无统计学意义(均P>0.05)。结论本地区产ESBLs肺炎克雷伯菌中CTX-M型ESBLs以CTX-M1组和CTX-M9组为主,有同时携带两组CTX-M基因菌株的检出;本地区CTX-M型ESBLs在产ESBLs肺炎克雷伯菌对头孢噻肟、头孢曲松和头孢他啶的耐药特征中不起主要作用。Objective To investigate the distribution and subtypes of blaCTX-M and antimicrobial resistance of extended-spectrum β-lactamase-producing Klebsiella pneumoniae .Methods Subgroups of CTX-M1,2,8 and 9 were detected by specific PCR in 74 non-replicated isolates of K. pneumoniae collected from four hospitals in Harbin. Antimicrobial susceptibilities to the clinical relevant broad-spectrum＂ β-lactams and β-lactam/inhibitor combinations were assayed by disk diffusion method. Resistance against cefotaxime, ceftazidime and ceftriaxome in isolates carrying blaCTX-M was compared with that in those without the gene. Results blaCTX-M9 and blaCTX-M8 were found in 25.7% and 39.2% of the ESBL-producing K. pneumoniae, respectively. Subtypes of blaCTX-M2 and blaCTX-M8 were not detected. No statistical differences were found about the resistance rates to cefotaxime, ceftazidime and ceftriaxome between strains with blaCTX-M and those without the gene detected. Conclusion It is revealed that blaCTX-M1 and blaCTX-M9 were most prevalent among the ESBL-preducing K. pneumoniae in Harbin. Isolates carrying genes belong to both subtypes were also found. Resistance patterns to cefotaxime, ceftazidime and ceftriaxome were not decided prominently by CTX-M-type ESBLs in this area.

关 键 词：肺炎克雷伯菌 blaCTX-M基因 耐药性 

分 类 号：R378.996[医药卫生—病原生物学]