变形杆菌临床分离株的耐药性分析及其AmpC酶的检测  

Analysis of drug-resistance and detection of AmpC-Typeβ-Lactamase in proteus

作　　者：陈晓莉[1] 徐元宏[1] 黄颖[2] 储洁[1] 王中新[2] 

机构地区：[1]安徽医科大学临床检验诊断学教研室,合肥230032 [2]安徽医科大学第一附属医院检验科,合肥230022

出　　处：《安徽医科大学学报》2007年第4期395-398,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省十五攻关二期科研基金资助项目(编号:040130583)

摘　　要：目的检测从临床标本中分离的146株变形杆菌对14种抗菌药物的体外活性以及产AmpC酶情况。方法药敏检测采用M-H肉汤微量稀释法,对头孢西丁耐药株以改良三维试验检测其产AmpC酶情况。PCR法检测AmpC基因型别,并进行了DNA测序分析。结果亚胺培南、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、氨曲南和三代、四代头孢菌素敏感率>80%。改良三维试验检测出单产AmpC酶奇异变形杆菌2株,检出率为1.4%(2/146)。DNA测序结果发现,2株变形杆菌所产AmpC酶均为CMY-2,基因序列已在基因库注册,授权号:EF534292。结论在变形杆菌中发现2株携带AmpC酶,其基因型为cmy-2。亚胺培南、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、氨曲南和三代、四代头孢菌素可作为治疗变形杆菌感染的首选药物。Objective To investigate the distribution of AmpC gene in the clinical proteus, detect the activity of 14 kind of antibiotics against 146 strains of proteus isolated so as to guide the rational application of antibiotics. Methods Antimicrobial susceptibility was tested by M-H broth microdilution. Modified three-dimensional extract test was adopted to detect the β-1actamase phenotype. The genotype of AmpC β-1actamase was determined by PCR and DNA sequencing. Results The rate of producing AmpC β-1actamase was 1.4% （2/146）. Of the 146 proteus,cmy- 2 AmpC gene was found in 2 clinical isolates. The gene was submitted to the GenBank database, accession number： EF534292. The sensitive rate of proteus clinical isolates to imipenem, ampicillin-sulbactam, piperacillin-tazobactam, amikacin, aztreonam, third-generation cephalosporins, fourth-generation cephalosporins were more than 80%. Con- Third-generation cephalosporins,fourth-generation cephalosporins, aztreonam, imipenem and amikacin are the first candidates for the infectious conditions caused by the proteus. CMY-2 AmpC β-1actamase is found in 2 P. mirabilis.

关 键 词：变形杆菌属/分离和提纯 抗药性 细菌 革兰阴性菌/酶学 

分 类 号：R378[医药卫生—病原生物学] R45[医药卫生—基础医学]