新生儿科产超广谱β-内酰胺酶肺炎克雷伯菌的耐药性分析及基因分型  

Antimicrobial resistance and gene typing of ESBLs Klebsiella pneumoniae for newborn

作　　者：陈汉斌[1] 

机构地区：[1]广州中医药大学附属南海妇产儿童医院新生儿科,广东南海528200

出　　处：《广州医学院学报》2011年第4期44-46,49,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:了解本院新生儿科送检标本中,分离的产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的耐药性及基因分型。方法:收集本院新生儿科送检标本中分离的肺炎克雷伯茵,采用双纸片协同试验的方法进行ESBLs初筛及表型确证试验;K-B纸片扩散法进行抗菌药物敏感性试验;聚合酶链反应(PCR)法分析ESBLs的基因分型。结果:产ESBLs肺炎克雷伯菌的检出率为71.11%(64/90)。产ESBLs肺炎克雷伯茵对第3代头孢菌素与β-内酰胺酶抑制剂合剂、碳青霉烯类抗生素较敏感。ESBLs的基因型分析结果显示,产ESBLs肺炎克雷伯茵中SHV、TEM、CTX-M-1基因扩增阳性率分别为71.64%、37.50%、49.79%,同时携带2种或3种耐药基因的菌株分别占37.71%和12.28%。结论:新生儿科产ESBLs肺炎克雷伯茵的耐药现象严重,ESBLs基因型以SHV、CTX-M-1为主。Objective：To investigate antimicrobial resistance and genotypes of ESBLs-producing Klebsiella pneumoniae from newborn department in our hospital. Methods： Klebsiella pneumoniae were collected from newborn department, ESBLs preliminary screen and phenotype confirmatory tests were carried out according to the NCCLS guidelines;Antimicrobial susceptibility tests were determined by Kirby-Bauer test;gene types of ESBLs were performed with PCR. Results：The detection rate of ESBLs-producing Klebsiella pneumoniae was 71.11% （64/90）. ESBLs-producing Klebsiella pneumoniae were sensitive to the combination of the third generation cephalosporins with lactamases inhibitor and carbapenems. The detection rate of genes of SHV, TEM, CTX-M-1 was 71.64% ,37.50% ,49.79%. 37.71% and 12.28% of ESBL-producing Klebsiella pneumoniae carried two or three genes respectively. Conclusion：Antimicrobial resistance of Klebsiella pneumoniae is serious, the main gene types are SHV and CTX-M-1.

关 键 词：肺炎克雷伯菌 超广谱13-内酰胺酶 耐药性 基因型 

分 类 号：R378.996[医药卫生—病原生物学]