2株耐碳青霉烯类肠杆菌科细菌发现新德里金属β-内酰胺酶基因  

Emergence of New Delhi metallo-β-lactamase 1 gene in two carbapenem-resistant Enterobacteriaceae strains

作　　者：康海全[1,2] 邓丽华[2] 施德仕[2] 赵晓杰[1] 姜飞[1] 李洪春[1,2] 马萍[1,2] 

机构地区：[1]徐州医学院医学技术学院,江苏徐州221004 [2]徐州医学院附属医院检验科,江苏徐州221002

出　　处：《临床检验杂志》2014年第6期457-459,共3页Chinese Journal of Clinical Laboratory Science

基　　金：徐州市科技项目合同-社会发展(XZZD1326)

摘　　要：目的调查新德里金属β-内酰胺酶1基因(New Delhi metallo-β-lactamase 1,blaNDM-1)在我院碳青霉烯类抗菌药物耐药肠杆菌科细菌中的流行状况。方法收集并鉴定临床分离碳青霉烯类抗菌药物耐药肠杆菌科细菌51株。药物敏感试验用琼脂稀释法;改良Hodge试验检测碳青霉烯酶;亚胺培南和亚胺培南+EDTA双纸片协同法检测金属β-内酰胺酶;PCR法检测blaNDM-1基因及其他主要的碳青霉烯酶基因(blaVIM、blaIMP、blaSIM、blaKPC、blaGES、blaSME、blaOXA-48),PCR扩增产物进行DNA测序分析。通过质粒转化试验来确定耐药基因的转移性。结果 1株阴沟肠杆菌和1株大肠埃希菌检出blaNDM-1基因,其他碳青霉烯酶基因阴性。2株细菌改良Hodge试验均为阳性,均产金属β-内酰胺酶,对所有的β-内酰胺类抗菌药物均耐药。耐药基因质粒转化试验阳性,转化子blaNDM-1基因检测阳性,并对青霉素类、头孢菌素类以及碳青霉烯类抗菌药物产生较高的耐药性。结论在本地区首次发现blaNDM-1基因,临床工作者应高度重视,加强对此类耐药基因的监测。Objective To investigate the prevalence of New Delhi metallo-β-lactamase 1 gene（blaNDM-1 ） in carbapenem-resistant Enterobacteriaceae isolates in our hospital. Methods A total of 51 clinical carbapenem-resistant isolates were collected and identified. Susceptibility testing for antibiotics was performed by the disc agar diffusion method. Carbapenemase production was confirmed by modified Hodge test, and metailo-β-lactamase（MBL） was detected by IPM/IPM-EDTA double disc synergy test. The blaNDM.1 gene and the other main carbapenemase-resistant genes（ blawM, blaIMP , blaSIM , blaKPC , blaGES , blaSME and blaOXA-48 ） were detected by PCR followed by DNA sequencing for the amplification products. Plasmid transformation test was used to determine the transferability of the resistant gene. Results The blaNDM.1 gene was detectable as positive in 1 Escherichia coli and 1 Enterobacter cloacae by PCR and DNA sequencing, and all the other carbapenemase-resistant genes were undetectable. Both of the isolates were positive for modified Hodge test and MBL producing, and were resistant to all the beta-lactam antibiotics and positive for plasmid transformation tests of drug-resistant gene. The products of transformants carried blaNDM-1 gene were high levels and resistant to antibacterial agents, e. g. , penicillin, cephalosporins and carbapenem. Conclusion The blaNDM-1 gene of New Delhi metallo-β-1actamase 1 was first reported in Xuzhou area, and high attention should be paid to monitoring blaNDM-1 gene and its drug-resistant mechanism.

关 键 词：新德里金属β-内酰胺酶1 肠杆菌科细菌 碳青霉烯酶 

分 类 号：R446.5[医药卫生—诊断学]