产质粒介导AmpC酶大肠埃希菌的耐药性及相关耐药机制  

Resistance and associated resistance mechanism of Escherichia coli producing plasmid-mediated AmpC β-lactamases

作　　者：王谦[1] 陈燕[1] 程君[1] 王迎迎[1] 叶英[1] 李家斌[1] 

机构地区：[1]安徽医科大学第一附属医院,合肥230022

出　　处：《中国抗生素杂志》2008年第2期106-110,127,共6页Chinese Journal of Antibiotics

基　　金：国家自然科学基金项目(30772286);安徽省自然科学基金项目(070413110)

摘　　要：目的了解安徽省35所医院2005年随机月份临床分离402株大肠埃希菌产质粒介导AmpC酶及对常用抗菌药物的耐药情况,揭示其相关耐药机制,指导临床合理用药方法三维试验筛选产AmpC酶株;多重PCR检测产质粒介导AmpC酶菌株,对产质粒介导AmpC酶菌株用PCR方法检测超广谱β-内酰胺酶(ESBLs)基因、Ⅰ类整合子基因盒插入序列和主动外排系统acrAB-tolC基因结果检出产质粒介导AmpC酶菌株28株(7.0%),其中2株经测序证实为新的质粒ampC基因型(GenBank登录号分别为EF054895,EF417572)产酶菌株对12种常用抗菌药物,除亚胺培南、美罗培南全部敏感外.对其他大多数抗菌药物耐药率均高于非产酶株28株产酶菌株中有23株表现为多重耐药,20株检测出各型ESBLs基因,21株扩增出Ⅰ类整合子基因盒插入序列,20株主动外排系统acrAB-tolC基因阳性结论产质粒介导AmpC酶大肠埃希菌对临床常用抗菌药物的耐药率均较高,多重耐药现象普遍,同时存在多种耐药机制,其中以产生灭活酶和Ⅰ类整合子介导的耐药机制为主对产酶株临床经验用药可选用碳青霉烯类、阿米卡星及第四代头孢菌素类抗菌药物。Objective To investigate the resistance of plasmid-mediated AmpC β-lactamase-producing Escherichla coll and analyze their associated resistance mechanism for the guidance of antibiotic rational use. Methods Three-dimensional extract test was adopted for detecting AmpC β-1actamases. The plasmid-mediated AmpC β-1actamases were detected by multiplex PCR. Extended-spectrum β-1actamases （ESBLs） gene, inserted gene cassettes of class 1 integrons and active efflux system acrAB-tolC gene were amplified by PCR. Results Of 402 isolates, 28 strains（7.0%） produced plasmid-mediated AmpC β-1actamases, and two arnpC genotypes were confirmed by DNA sequence analysis （GenBank accession is EF054895 and EF417572, respectively）. For 12 testing antimicrobials,all strains were all sensitive to imipenem and meropenem and the resistant rates of AmpC β-1actamase-producing strains were higher than the non-producers against other antibiotics. Of 28 strains AmpC β-1actamase producers, 23 strains were detected multiple-drug resistance, 20 strains carrying ESBLs-encoding genes, 21 strains with class 1 integrons sequence, and 20 strains having acrAB-tolC gene. Conclusions AmpC β-lactamase-producing E. coli were highly resistant to most kinds of antibiotics and with

关 键 词：质粒介导 AMPC酶 大肠埃希菌 耐药性 耐药机制 

分 类 号：R378.21[医药卫生—病原生物学]