金黄杆菌属连续5年耐药性监测与β-内酰胺酶的检测  

Drug Resistance and Detection of β-Lactamase from Chryseobacterium spp:A Five Year Surveillance

作　　者：董杰[1] 张嵘[2] 周宏伟[2] 陈功祥[2] 

机构地区：[1]浙江省血液中心检验科,浙江杭州310000 [2]浙江大学医学院附属第二医院临床检验中心,浙江杭州310009

出　　处：《中华医院感染学杂志》2008年第10期1476-1479,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解医院金黄杆菌属的分离和耐药情况,并探索其产生耐药的机制。方法对医院5年间分离的金黄杆菌属进行鉴定和K-B法药敏试验;同时选择43株脑膜脓毒金黄杆菌、16株产吲哚金黄杆菌和10株黏金黄杆菌共69株,用琼脂稀释法检测14种抗菌药物的最低抑菌浓度(MIC);用三维试验和协同试验筛选超广谱β-内酰胺酶及碳青酶烯酶。结果2001年1月-2005年12月5年间共检出金黄杆菌属1128株,其中脑膜脓毒金黄杆菌占88.3%、产吲哚金黄杆菌占8.0%、黏金黄杆菌占2.9%,其他金黄杆菌占0.8%;金黄杆菌属除了喹诺酮类抗菌药物的MIC50和MIC90较低外,其余的抗菌药物均很高;脑膜脓毒金黄杆菌金属酶阳性率为60.5%,产吲哚金黄杆菌阳性率为68.8%,黏金黄杆菌阳性率为90.0%。结论金黄杆菌属对多种抗菌药物耐药,不同种类的金黄杆菌属对不同的抗菌药物耐药性有很大的差异,金黄杆菌属的耐药机制主要是产生了以金属酶为主的β-内酰胺酶。OBJECTIVE To investigate the isolation and drug resistance of Chryseobacterium spp in our hospital, and to explore the mechanisms of drug resistance. METHODS Bacteria were identified in our hospital for the last five years （Jan 2001- Dec 2005） and the antimicrobial susceptibility was tested by Kirby-Bauer plate dilution method. Forty-three isolates of C. meningosepticum, 16 isolates of C. indologenes and 10 isolates of C. gleum were isolated and selected for further studies. Minimum inhibitory concentrations （MICs） against 14 antibiotics were determined by the agar dilution method. Extended-spectrum β-lactamase （ESBL） and carbapenemase were detected by three-dimensional test and 2-mercaptopropionic acid inhibitory test. RESULTS One thousand and one hundred twenty-eight Chryseobacterium and others strains in total were isolated during the described period. Among them C. meningosepticum, C. indologenes, C. gleum, and other Chryseobacterium species were 88.3%, 8.0%, 2.9%, 0.6% and 0.2%, respectively. The resistant ratios against antibiotics containing enzyme inhibitors were lower than other antibiotics. The MICs0 and MIC90 against most antibiotics were high except for quinolones. As for carbapenemase, the positive rate was 60. 5%, 68.8% and 90.0% in C. meningosepticum, C. indologenes, and C. gleurn, respectively. CONCLUSIONS Chryseobacterium are highly resistant against a variety numbers of antibiotics. Nevertheless, there exists a significant difference in the resistance against different antibiotics for different species of Chryseobacterium. The major drug resistant mechanism in Chryseobacterium is due to the production of β-lactamases, especially metallo-β-lactamases.

关 键 词：金黄杆菌属 Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]