弗氏柠檬酸杆菌β-内酰胺酶检测及耐药性分析  

Detection of β-Lactamases produced by Citrobacter freundii and analysis of drug resistance

作　　者：吴荣辉[1] 何建新[1] 金小珍[1] 

机构地区：[1]义乌市中心医院检验科,浙江义乌322000

出　　处：《中华医院感染学杂志》2013年第24期6112-6114,共3页Chinese Journal of Nosocomiology

基　　金：义乌市医学重点学科建设基金资助项目(13-ZD05)

摘　　要：目的观察弗氏柠檬酸杆菌临床分离株产超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC)、金属酶(MBLs)、KPC型碳青霉烯酶情况,并分析其对19种常见抗菌药物的耐药性。方法选取医院2008年7月-2012年12月门诊、住院患者各类送检标本中分离出的弗氏柠檬酸杆菌,采用三维试验检测ESBLs和AmpC及MBLs,采用改良Hodge试验检测KPC型碳青酶烯酶,并以K-B法测定对常见抗菌药物的耐药性。结果共172株弗氏柠檬酸杆菌单产超广谱β-内酰胺酶(ESBLs)46株,检出率26.74%;单产头孢菌素酶(AmpC)23株,检出率13.37%;同时产ESBLs及Amp C27株,检出率15.70%;产碳青霉烯酶33株,检出率19.19%;单产ESBLs、单产AmpC、同产ESBLs+AmpC弗氏柠檬酸杆菌分离株对亚胺培南、美罗培南的耐药率<12.0%,与非产酶菌株相比,差异无统计学意义;对其余抗菌药物的耐药率均明显高于非产酶菌株(P<0.05)。结论医院弗氏柠檬酸杆菌临床分离株产生多种β-内酰胺酶,且对常用抗菌药物呈高度耐药。OBJECTIVE To observe the production of extended-spectrum β-lactamases （ESBLs）, cephalosporinase （AmpC）, and metallo-β-laetamase （MBLs）, and KPC carbapenemase by Citrobacter freundii and analyze the drug resistance to 19 commonly used antibiotics. METHODS The C. freundii strains were isolated from the various submitted specimens obtained from the outpatients and hospitalized patients who were treated in the hospital from Jul 2008 to Dec 2012, then the three dimensional test was performed for the detection of ESBLs, AmpC, and MBLs, the modified Hodge trial was carried out to detect the KPC type carbapenemase, and the drug resistance to the commonly used antibiotics was determined with the use of K-B method. RESULTS Of totally 172 strains of C. freundii, there were totally 46 （26. 74%） isolates of ESBLs-producing strains, 23 （13. 37%） isolates of AmpC-producing strains, 27 （15. 70%） isolates of ESBLs and AmpC-producing strains, and 33 （19.19%） isolates of carbapenemase-producing strains. The drug resistance rates of the ESBLs-producing strains, AmpC-producing strains, and ESBLs plus AmpC-producing strains to imipenem and meropenem were less than 12.0%, as compared with the non-enzyme-producing strains, the difference was not statistically significant~ the drug resistance rates to the rest of antibiotics of such strains were significantly higher than those of the non-enzyme strains （P〈0.05）. CONCLUSION The clinical isolates of C. freundii can produce a variety of β-lactamases and are highly resistant to the commonly used antibiotics.

关 键 词：弗氏柠檬酸杆菌 超广谱Β-内酰胺酶 头孢菌素酶 金属酶 KPC型碳青霉烯酶 耐药率 

分 类 号：R378[医药卫生—病原生物学]