碳青霉烯类药物非敏感肠杆菌科细菌基因型研究  

Genotype analysis of carbapenem-non-susceptible Enterobacteriaceae

作　　者：胡雪[1,2] 林迪[2] 陈坚[2] 杨丽君[2] 杨燕[2] 成军[2] 陈东科[3] 曾贤铭[2] 孙长贵[2] 

机构地区：[1]江苏大学基础医学与医学技术学院,江苏镇江212013 [2]解放军第117医院检验科,杭州310013 [3]卫生部北京医院检验科,北京100730

出　　处：《临床检验杂志》2013年第10期736-739,共4页Chinese Journal of Clinical Laboratory Science

基　　金：南京军区医学科技创新重点课题(10Z037)

摘　　要：目的探讨临床分离的碳青霉烯类药物非敏感肠杆菌科细菌的基因型。方法收集2010年1月至2013年6月临床标本中分离的碳青霉烯类药物非敏感肠杆菌科细菌110株,K-B纸片扩散法检测细菌对临床常用药物的敏感性,纸片扩散表型确证试验检测超广谱β-内酰胺酶(ESBLs),改良Hodge试验(MHT)检测碳青霉烯酶表型,PCR、DNA测序及BLAST比对等方法确定菌株耐药基因型。结果 110株碳青霉烯类非敏感肠杆菌科细菌中,MHT阳性77株(70.0%)。31株大肠埃希菌、1株产气肠杆菌和1株黏质沙雷菌检出bla KPC-2基因,5株阴沟肠杆菌和1株产气肠杆菌分别检出bla IMP-26和bla VIM-2基因。36株32.7%菌株ESBLs表型试验阳性,主要检出bla CTX-M-15、bla SHV-12和bla CTX-M-33种ESBLs基因型。结论本项研究碳青霉烯类非敏感肠杆菌科细菌以bla KPC-2基因型为主,其次为bla IMP-26和bla VIM-2基因型。Objective To investigate the genotype of carbapenem-non-suseeptible Enterobacteriaceae isolated from clinical specimens in our hospital. Methods A total of 110 clinical isolates of carbapenem-non-susceptible Enterobacteriaceae were isolated from clinical specimens in our hospital during January 2010 to June 2013. The susceptibility of isolates to carbapenems was determined by the disk diffusion method. The extended-spectrum β-lactamases （ESBLs） and the carbapenemase phenotypes of isolates were detected by the phenotypic confirmatory test and the modified Hodge test （ MHT）, respectively. Further, the genotypes of β-lactamases were determined by polymerase chain reaction （PCR） , DNA sequencing and BLAST aligning. Results Of 110 isolates of carbapenem-non-susceptible Enterobacteriaceae, 77 （70.0%） were positive for carbapenemase. PCR and DNA sequencing analysis showed that 31 isolates of E. coli, 1 E. aerogenes and 1 S. marcescens carried with blaKPC-2 gene, 5 isolates of E. cloacae with blaIMP-26 and 1 E. aerogenes with blaVIM-2. In addition, 36 （32.7%） of isolates produced ESBLs, and 3 genotypes, such as blaCTX-15, blaSHV-12 and blaCTX-3 , were detected. Conclusion blaKPC-2 was the major genotype of carbapenemase for the clinical isolates of carbapenem-non-susceptible Enterobacteriaceae in our hospital, followed by blaIMP-26 and blaVIM-2.

关 键 词：肠杆菌科 碳青霉烯类 基因型 耐药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]