产ESBLs肺炎克雷伯杆菌SHV型β-内酰胺酶临床研究  

Genotying and drug resistance and gene mutation of SHV β- lactamase of extended Spectrum Beta lactamase-producing Klebsiella Pneumoniae

作　　者：蔡朝民[1,2] 程明刚[1,2] 刘香萍[1,2] 曹建华[1,2] 叶国强[1,2] 黄国妮 袁建辉[3] 

机构地区：[1]深圳市宝安区人民医院 [2]南方医科大学附属宝安医院检验科,广东深圳518101 [3]深圳市疾病预防控制中心,广东深圳518055

出　　处：《中国热带医学》2013年第12期1528-1529,1537,共3页China Tropical Medicine

摘　　要：目的探讨产ESBLs肺炎克雷伯杆菌中SHV分型、耐药性及基因突变类型。方法收集肺炎克雷伯杆菌516株,其中168株产ESBLs,分析其基因类型;对产ESBLs肺炎克雷伯杆菌SHV型进行耐药试验及其基因突变类型检测。结果 168例产ESBLs肺炎克雷伯杆菌株中,其中CTX-M基因型38株(22.6%),SHV基因型105株(62.5%),TEM基因型25株(14.9%);SHV分型主要有SHV-1、SHV-6、SHV-8、SHV-10、SHV-12、SHV-18和SHV-71,其中SHV-6型例数最多,为42例;产ESBLs肺炎克雷伯杆菌株SHV型对抗生素广泛性耐药,仅亚胺培南/西司他丁对所有菌株均敏感;SHV基因突变类型主要为碱基置换和移码。结论探讨不同地区产ESBLs肺炎克雷伯杆菌基因突变分型及药敏试验对抗生素的选择具有重要的临床价值。Objective To investigate the genotyping,drug resistance and gene mutations of SHV β-lactamase of extended specrtum beta lactamase （ESBLs）-producing Klebsiella pneumoniae. Methods The 168 strains of ESBLs -producing Klebsiella pneumoniae were collected and genotype, drug resistance and gene mutation sof SHV β -lactamase of ESBLs- producing Klebsiella pneumoniae were carried out. Results There were 38 CTX-M strains, 105 HSV strains and 25 TEM strains in 106 ESBLs -producing Klebsiella pneumoniae, strains The incidence of drug resistance of SHV β-lactamase of ESBLs -producing Klebsiella pneumoniae were intensive and all strains were sensitive only to imipenem/cilastatin. The major mutation gene models were base replacement and frame shift. Conclusions Gene mutation genotyping of β-lactamase of ESBLs- producing Klebsiella pneumoniae and drug resistance test is of great significance for chnical selection of antibiotic.

关 键 词：广谱Β-内酰胺酶 肺炎克雷伯杆菌 临床研究 

分 类 号：R378.1[医药卫生—病原生物学]