哈尔滨地区肺炎克雷伯菌质粒型AmpC酶基因型检测及耐药性分析  

Detection of Genotypes of Plasmid-mediated AmpC β-Lactamase and Analysis of Antimicrobial Resistance of Klebsiella pneumoniae in Harbin

作　　者：张文莉[1] 张凤民[1] 付英梅[1] 许建丰[1] 陈小贝[1] 马佳毓[1] 刘树林[1] 

机构地区：[1]哈尔滨医科大学微生物学教研室,黑龙江哈尔滨150081

出　　处：《中华医院感染学杂志》2008年第4期477-480,共4页Chinese Journal of Nosocomiology

基　　金：国家科技攻关项目(2004BA720A09-02);黑龙江省卫生厅资助课题(2005-13)

摘　　要：目的确定哈尔滨地区临床分离产质粒型AmpC酶肺炎克雷伯菌基因型别,分析其耐药表型与基因的关系。方法收集临床分离头孢西丁抑菌环直径≤18mm的肺炎克雷伯菌,用6组PCR特异引物检测AmpC酶基因型别。结果231株肺炎克雷伯菌中,63株头孢西丁抑菌环直径≤18mm,其中产AmpC酶菌26株,占11.3%;PCR检测ACT、DHA和CIT型分别为13、8、5株,有5株菌同时产ACT型和DHA型AmpC酶,未检测到ACC、MOX和FOX型存在;AmpC阳性株对头孢西丁、头孢噻肟、头孢他啶、阿莫西林/克拉维酸、环丙沙星、阿米卡星、亚胺培南的耐药率分别是76.9%、70.2%、53.8%、50.0%、57.7%、38.5%、7.7%。结论哈尔滨地区产AmpC酶主要为ACT、DHA和CIT型,AmpC阳性株对头孢西丁和三代头孢菌素耐药性较高。OBJECTIVE To determine the drug resistance phenotype and genotype of plasmid-mediated AmpC β-lactamase in Klebsiella pneumoniae isolated from Harbin.METHODS Isolates of K.pneumoniae with an inhibition ring to cefoxitin of ≤18 mm diameter were used.Antimicrobial susceptibilities were determined by disc diffusion method.AmpC genes were detected by PCR with six pairs of primers.RESULTS Sixty-three isolates had an inhibition ring to cefoxitin of ≤18 mm diameter and 26（11.3%）were detected to be AmpC-producing in a total of 231 clinical isolates of K.pneumoniae.Seventy-six percent,70.2%,53.8%,50.5%,57.7%,38.5% and 7.7% of AmpC-producers were resistant to cefoxitin,cefotaxime,ceftazidime,amoxicillin/clavulanic cid,ciprofloxacin,amikacin and imipenem,respectively.ACT,DHA and CIT types of AmpC beta-lactamase were detected in 13,8 and 5 isolates,respectively.No ACC,MOX and FOX were detected.CONCLUSIONS The AmpC β-lactamase in Harbin is mainly in the types of ACT,DHA and CIT.AmpC-producing K.pneumoniae shows decreased susceptibilities to cefoxitin and third generation cephalosporins.

关 键 词：肺炎克雷伯菌 AMPC酶 耐药基因 

分 类 号：R378.996[医药卫生—病原生物学]