阴沟肠杆菌产超广谱β-内酰胺酶、AmpC酶的检测及耐药性分析  

Detection of Extended-spectrum β-Lactamases and AmpC β-Lactamases and Analysis of Drug Resistance in Enterobacter cloacae

作　　者：李岩[1] 许淑珍[1] 苏建荣[1] 刘志远[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中华医院感染学杂志》2007年第12期1586-1589,共4页Chinese Journal of Nosocomiology

摘　　要：目的调查产超广谱β-内酰胺酶(ESBLs)、AmpC酶阴沟肠杆菌基因型及其耐药性,以期为临床治疗提供依据。方法使用VITEK-AMS鉴定细菌;采用三维试验检测阴沟肠杆菌的ESBLs与AmpC酶表型;β-内酰胺酶耐药基因型检测采用PCR扩增技术;耐药基因水平传播采用质粒接合试验;根据美国临床实验室标准化研究所(CLSI)指南进行药敏试验。结果86株阴沟肠杆菌中ESBLs携带率为48.8%;CTX-M型为主要类型,其中CTX-M-3亚型为27.9%,CTX-M-9亚型为16.3%,CTX-M-14亚型为3.4%;SHV-12型为18.6%;11株同时产ESBLs与AmpC酶,占12.8%,31株单独产ESBLs(36.0%),8株单独产高产AmpC酶(9.3%);亚胺培南对ESBLs菌株的敏感率为100.0%;8株产ESBLs菌株接合试验成功。结论CTX-M型与SHV-12型是阴沟肠杆菌ESBLs的主要基因型。ESBLs可以通过质粒接合试验进行水平传播。OBJECTIVE To investigate the genotypes of extended-spectrum β-lactamases（ESBLs）and drug resistance in Enterobacter cloacae for clinical treatment.METHODS E.cloacae was identified by VITEK-AMS,ESBLs and AmpC β-lactamases phenotypes were detected by three-dimensional tests.Detection of β-lactamases resistant genes were performed by PCR.Plasmid conjugation test was used to determine the location and the transmission of encoding genes of β-lactamases.The antibotic susceptibility of E.cloacae was detected according to the CLSI guideline.RESULTS The incident rate of ESBLs producing E.cloacae was 48.8% in 86 strains.CTX-M was the main type of ESBLs.The detection rate of CTX-M-3,CTX-M-9,CTX-M-14 and SHV-12 genotypes in isolates were 27.9%,16.3%,3.4% and 18.6%,respectively.Strains producing both ESBLs and AmpC β-lactamases were 11（12.8%）.The strains only producing ESBLs or AmpC β-lactamases were 31（36.0%） and 8（9.3%）,respectively.The sensitive rate of ESBLs isolates to imipenem was 100.0%.Eight ESBLs strains were conjugated successfully.CONCLUSIONS CTX-M and SHV-12 are the main genotypes of ESBLs strains.ESBLs genes can be horizontally transferred to recipient by plasmid conjugated test.

关 键 词：阴沟肠杆菌 Β-内酰胺酶类 耐药 

分 类 号：R378[医药卫生—病原生物学]