多重耐药菌中β-内酰胺酶的基因型研究  

Study on β-lactamase genotypes in multi-drug resistant bacterial isolates

作　　者：陈定强[1] 彭玉婷[1] 罗毓婷[1] 徐韫健[1] 林勇平[1] 杨羚[1] 

机构地区：[1]广州医学院第一附属医院检验科,510120

出　　处：《检验医学与临床》2013年第1期1-3,共3页Laboratory Medicine and Clinic

基　　金：广州医学院青年基金项目(2010A13和2010A14)

摘　　要：目的调查β-内酰胺酶在临床分离的多重耐药大肠杆菌和肺炎克雷伯菌中的流行状况,并分析不同基因型的分布特征。方法针对2009～2010年间收集的59株多重耐药大肠杆菌和肺炎克雷伯菌,采用VITEK-2全自动细菌鉴定仪检测大肠杆菌和肺炎克雷伯菌对抗菌药物的耐药性。用煮沸法提取菌株的总DNA,并用多重聚合酶链反应(PCR)对21种β-内酰胺酶基因进行检测。结果 59株多重耐药菌对青霉素类、头孢菌素类和喹诺酮类抗菌药物耐药性非常严重,耐药率均达90%以上。多重PCR共检出含TEM基因菌株32株,CTX-M-G9基因31株,SHV基因27株,CTX-M-G1基因19株,CTX-M-G2基因14株,DHA基因4株,MOX基因2株,CMY基因、OXA-1基因和ACT基因各1株。未检测到含GES、VEB、IMP、VIM、KPC、CTX-M-G8/25、ACC、FOX、PER、OXA-48等基因的菌株,多个菌株发现携带两种以上耐药基因。结论多重耐药菌中β-内酰胺酶种类分布非常广泛,其中以TEM、CTX-M和SHV基因最为常见,某些菌株同时携带多种β-内酰胺酶基因,临床进行抗菌治疗时应引起重点关注。Objective To investigate the prevalence and genotype distribution of β-lactamases in multi-drug resistant Escherichia coli and Klebsiella pneumoniae clinical isolates.Methods Fifty-nine multi-drug resistant E.coli and K.pneumoniae strains were isolated between 2009 and 2010.Antimicrobial susceptibility was detected by VITEK-2 automated bacterial analyzer.The total DNA was extracted by boiling methods and 21 β-lactamase genotypes were detected by polymerase chain reaction（PCR）.Results Resistance to penicillins,cephalosporins and quinolones were detected in more than 90% of the strains.No Imipenem resistant strains were detected.TEM,CTX-M-G9,SHV,CTX-M-G1,CTX-M-G2,DHA,MOX,CMY,OXA and ACT genes were detected in 32,31,27,19,14,4,2,1,1,1 of the 59 multi-drug resistant isolates,respectively.Strains positive for GES,VEB,IMP,VIM,KPC,CTX-M-G8/25,ACC,FOX,PER and OXA-48 were not detected.Conclusion β-lactamase genes were commonly identified among multi-drug resistant bacteria,and TEM,CTX-M and SHV genes were found with the highest frequency.Some of these bacteria carried several β-lactamase genes in one strain,and attentions should be highly paid in antimicrobial therapy against these bacteria.

关 键 词：多重耐药菌 Β-内酰胺酶 基因型 

分 类 号：R378.911[医药卫生—病原生物学]