肺炎克雷伯菌和大肠埃希菌产质粒AmpC酶的检测和耐药分析  

Dectection and antimicrobial resistance of plasmid-mediated AmpC β-lactamases produced by K. pneumoniae and E. coli

作　　者：范爱民[1] 田秀红 

机构地区：[1]山西省人民医院,030012 [2]山西省职工医学院附属医院

出　　处：《山西医药杂志（上半月）》2009年第11期998-1000,共3页Shanxi Medical Journal

摘　　要：目的调查我院部分大肠埃希菌和肺炎克雷伯菌产质粒AmpC酶的情况和耐药性。方法收集我院1492株大肠埃希菌和肺炎克雷伯菌临床分离株,K-B法测定对部分药物敏感性,三维试验检测产AmpC酶菌株,多重聚合酶链反应(PCR)检测菌株基因型。结果52株三维试验阳性,19株大肠埃希菌产质粒AmpC酶(12株为DHA-1,7株为CMY-2),12株肺炎克雷伯菌产质粒AmpC酶(10株为DHA-1,2株为CMY-2),产酶株对第三代头孢菌素耐药率均较高,对第四代头孢菌素耐药率为60%,对亚胺培南、美罗培南等碳青霉烯类耐药率最低。结论大肠埃希菌和肺炎克雷伯菌产AmpC酶是造成对第三代和第四代头孢菌素耐药的主要原因,最常见的基因型为DHA-1型,对产酶株进行检测有助于大肠埃希菌和肺炎克雷伯菌感染的控制。Objective To investigate the plasmid AmpC （pAmpC） produced by K. pneumoniae and E. coli and their antimicrobial resistance. Methods One thousand four hundred and ninty-two strains of K. pneumoniae and E, coli were isolated from patients, antimicrobial susceptibility was tested by K -B three dimensional extract test was adopted for detecting plasmid AmpC β-lactamases and the genetype was detected by PCR. Results Fiftytwo isolates were positive by three dimensional test, plasmid AmpC was produced by 19 E. coli （12 DHA-1, 7 CMY-2） and 12 K. pneumoniae （10 DHA-1, 2 CMY-2）. The resistant rate of pAmpC producing strains were high to third-generation cephalosporins, and 60% strains were resistant to fourth-generation cephalosporins. Conclusion pAmpC is the main cause of antimicrobial resistance of E. coli and K. pneumoniae to third-generation and fourth-generation cephalosporins, the most common one is DHA-1 type. Detection of these pAmpC producers helps the injection control of E. coli and K. pneumoniae.

关 键 词：克雷伯菌 肺炎 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学] R450[医药卫生—临床医学]