安徽省产CTX-M型超广谱β-内酰胺酶的肺炎克雷伯菌耐药性和基因型研究  

Studies on resistance and genotypes of CTX-M extended-spectrum β-Iactamase-producing Klebsiella pneumoniae in Anhui province

作　　者：高伟[1] 孙震[1] 殷俊[1] 王谦[1] 程君[1] 叶英[1] 李家斌[1,2] 

机构地区：[1]安徽医科大学第一附属医院,合肥230022 [2]安徽省细菌耐药性监控中心,合肥230022

出　　处：《中国抗生素杂志》2009年第1期48-51,共4页Chinese Journal of Antibiotics

基　　金：国家自然科学基金项目(30571654);安徽省自然科学基金项目(070413110)。

摘　　要：目的了解安徽地区产CTX-M型超广谱β-内酰胺酶(ESBIs)的肺炎克雷伯菌检出率,确定其基因型,并对其流行病学特征进行研究。方法纸片法进行表型鉴定;PCR检测产CTX-M型超广谱β-内酰胺酶菌株;分析基因型;琼脂稀释法进行药物敏感试验。结果52株肺炎克雷伯菌经通用引物PCR检测证实产CTX-M酶,占所有分离菌株的23.4%(52/222),占产ESBLs菌株的49.5%(52/105);经序列分析显示:15株CTX-M-1组阳性结果有12株表达CTX-M-22,2株表达CTX-M-15,1株表达CTX-M-3;37株CTX-M-9组阳性结果有35株表达CTX-M-14,2株表达CTX-M-24;CTX-M-2组和CTX-M-8组未检测出;其中有2株新基因被检出(序列号分别为EU136031和EU202673);药敏结果显示临床野生菌株对多种β-内酰胺类耐药,对哌拉西林/三唑巴坦、阿米卡星、头孢他啶相对较敏感。结论安徽地区CTX-M酶以CTX-M-14型和CTX-M-22型为主,同时存在变异型;药敏结果显示产酶菌株对头孢噻肟和头孢曲松、氨苄西林高度耐药。Objective To investigate the CTX-M extended spectrum β-lactamases （ESBLs） gene and prevalence in Klebsiella pneumoniae strains isolated from Anhui Province. Methods Drug resistant test ot UIX-M- producing isolates was performed by mueller-hinton agar dilution and disc diffusion confirmatory test. Groups of CTX-M were detected by PCR in all ESBLs-producing KlebsieUa pneumoniae strains. The PCR products were directly sequenced and analyzed. Results Positive amplification results were observed for 52 K. pneumonia isolates with pro- ducing CTX-M type. The percentage of CTX-M-producing isolates in all isolates and ESBLs positive strains were 23.4% and 49.5%, respectively. Sequence and alignment results indicated that positive results for CTX-M-1 group were comprised with those of 12 CTX-M-22 carried strains; 2 CTX-M-15 carried strains and 1 CTX-M-3 carried strain; positive results for CTX-M-9 group were comprised of 35 CTX-M-14 producing isolates and 2 CTX-M-24 carried strains; CTX-M-2 and CTX-M-8 groups were not detected. The wild-type isolates were resistant to most of β-lactama antibiotics and susceptible to piperacillin/tazobactam, amikacin, and ceftazidime, respectively. Conclusions CTX-M-14 and CTX-M-22 were the mainly epidemic genotypes of CTX-M-producing isolates in Anhui province. Moreover, two novel subtypes of CTX-M-14 and CTX-M-3 were found. All the wild-type isolates exhibited high resistant to ceftriaxone, piperacillin and cefotaxime.

关 键 词：超广谱β-内酰胺酶类 肺炎克雷伯菌 CTX-M基因 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]