碳青霉烯类耐药肺炎克雷伯菌多重β-内酰胺酶基因型研究  

Study on genotype of multiple β-lactamases in carbapenem-resistant Klebsiella pneumoniae

作　　者：高丽华[1] 齐艳[1] 吕凌云[1] 

机构地区：[1]浙江省杭州市中医院检验科,杭州310003

出　　处：《中国卫生检验杂志》2012年第6期1426-1428,1433,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的:研究医院感染碳青霉烯类耐药肺炎克雷伯菌中碳青霉烯酶、超广谱β-内酰胺酶(ESBLs)和质粒介导的AmpC酶基因型的分布。方法:筛选出产KPC酶肺炎克雷伯菌,采用改良的Hodge试验、接合试验、聚合酶链反应(PCR)等方法确定多重β-内酰胺酶基因型。结果:收集并证实产KPC-2型碳青霉烯酶肺炎克雷伯菌26株,其中CTX-M型ESBL检出率最高;3株细菌同时编码ESBL和AmpC基因,其中2株细菌同时携带blaCTX-M-3、blaSHV-12和blaDHA-1三种β-内酰胺酶基因。结论:产KPC酶肺炎克雷伯菌同时携带有其他β-内酰胺酶耐药基因,CTX-M型ESBL最为常见,使细菌耐药性更为严重。Objective：To investigate the distribution of genotypes of extended-spectrum β-lactamases（ESBL）and plasmid-mediated AmpC β-lactamase in carbapenem-resistant Klebsiella pneumoniae isolates.Methods：Modified Hodge,Plasmid conjugation and PCR were used for analyzing the genotype of multiple β-lactamases in KPC-producing K.pneumoniae.Results：Twenty-six isolates of KPC-2-producing K.pneumoniae were col-lected and confirmed.Among these isolates,CTX-M-type ESBLs had the highest detection rate.three isolatescontained both ESBLs and AmpC genes,and two of them contained blaCTX-M-3,blaSHV-12and blaDHA-1 genes simulta-neously.Conclusion：Other β-lactamases resistant genes were coexistent in KPC-producing K.pneumoniae,CTX-M-type ESBLs were the most common genotypes,which can increase the drug resistance of β-lactamases.

关 键 词：肺炎克雷伯菌 KPC Β-内酰胺酶 基因 PCR 

分 类 号：R378.996[医药卫生—病原生物学]