阴沟肠杆菌产AmpC酶和ESBLs的检测及其耐药机制研究  

The test drug resistance mechanism of Enterobacter cloacae with AmpC and ESBLs β-lactamases

作　　者：隋秀丽[1] 苏维奇[2] 

机构地区：[1]山东省文登整骨医院,山东文登264400 [2]青岛市市立医院,山东青岛266011

出　　处：《中国实验诊断学》2010年第8期1255-1257,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解阴沟肠杆菌临床分离株AmpC酶和ESBLs的产生情况并分析其耐药特性,为临床合理使用抗菌药物提供依据。方法采用改良的酶提出物三维试验法对186株阴沟肠杆菌进行AmpC酶和ESBLs检测,用K-B法对14种常用抗菌药物进行药物敏感试验。结果 186株阴沟肠杆菌中,产AmpC酶的菌株63株,占33.9%;产ESBLs的菌株有28株,占15.1%;同时产AmpC酶和ESBLs的菌株有18株,占9.7%。药敏结果显示,186株阴沟肠杆菌对头孢唑林、氨苄西林、头孢西丁等抗菌药物的耐药率较高,对亚胺培南、舒普深的耐药率较低。结论阴沟肠杆菌已呈现出多重耐药性,其耐药机制较为复杂,可表现为阻遏高产AmpC酶、产ESBLs,也可表现为同时产AmpC酶和ESBLs等多种耐药表型。Objective To investigate the extened spectrum β-lactamases （ESBLs） and AmpC β-lactamases of Enterobacter cloacae of clinical isolates. Antimierobial agents should be used rationally based on the results of susceptibility testing.Methods To test the ESBLs and AmpC of 186 strains of Enterobacter cloacae by improved three-dimensional extraction. Using the Kirby - Bauer （KB） antibiotic susceptibility test to 14 kinds of conunon antimicrobial agents. Results Threr were 63 strains producing AmpC β-lactamases （33.9%）, 28 strains producing ESBLs（ 15.1% ） and 18 trains producing both AmpC and ESBLs β-lactamases（9.7% ）. The result of antibiotic susceptibility tese showed that in 186 strains Enterobacter cloacae were highly resistant to CZ, AMP, CEFet al and low resistant to imipenem and sulperazone. Conclusion Multi-drug resistance of Rnterobacter cloacae were remarkable, and the drug resistance mechanism was quite complex. The strains that expressed hyperproduction of AmpC β-lactamases only, ESBI.s only, or both Am- pC and ESBLs at the time.

关 键 词：阴沟肠杆菌 AMPC酶 ESBLS 耐药性 

分 类 号：R446.5[医药卫生—诊断学]