儿童感染耐碳青霉烯酶肠杆菌的耐药表型及耐药基因研究  

Drug-resistance phenotypes of carbapenemase-resistant Enterobacter causing infections in children and resistance genes

作　　者：邢金芳[1] 贾莉婷[1] 张霞[1] 泰淑红[1] 荣守华[1] 孟祥颖[1] 胡玉芬[1] 田伟芳[1] 

机构地区：[1]郑州大学第三附属医院检验科,河南郑州450052

出　　处：《中华医院感染学杂志》2014年第14期3381-3383,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅基金资助项目(HW-2010B-019)

摘　　要：目的探讨儿童感染耐碳青霉烯酶肠杆菌的耐药表型及其耐药基因,提高儿童感染耐碳青霉烯酶肠杆菌的耐药表型及其耐药基因的认识及诊治水平。方法选择2009年3月-2013年3月儿科送检标本中分离的多药耐药肠杆菌标本共31份,使用VITK-2全自动细菌检定仪对细菌进行鉴定以及药敏试验,并进行PCR法检测耐药基因。结果 13株大肠埃希菌对厄他培南、氨苄西林、哌拉西林的耐药率均达100.0%;9株肺炎克雷伯菌对氨苄西林、哌拉西林、头孢他啶的耐药率均达100.0%;9株阴沟肠杆菌对厄他培南、氨苄西林、哌拉西林、头孢哌酮/舒巴坦的耐药率均达100.0%;通过耐药基因扩增结果显示,31株细菌中携带有耐药基因的有29株,其中以blaTEM-1基因、blaCTX-M-3基因、blaTEM-1基因等较为常见。结论医院儿童感染耐碳青霉烯酶肠杆菌对多种抗菌药物的耐药率较高,且大部分的耐碳青霉烯酶肠杆菌均携带有耐药基因,为了预防耐碳青霉烯酶肠杆菌的发生,临床中应规范抗菌药物的使用,并根据药敏试验的结果指导临床抗菌药物的使用。OBJECTIVE To explore the drug-resistance phenotypes of carbapenemase-resistant Enterobactercausing infections in children and analyze the drug resistance genes so as to improve the awareness of the drug-resistance phenotypes of carbapenemase-resistant Enterobactercausing infections in the children and raise the level of diagnosis and treatment.METHODS From Mar 2009to Mar 2013,totally 31strains of multidrug-resistant Enterobacter were isolated from the submitted specimens obtained from the department of pediatrics,then the identification of the strains was carried out by using the VITK-2automatic bacteria identification system,the drug susceptibility testing was performed,and the resistance genes were tested with use of PCR.RESULTS The drug resistance rates of 13 Escherichia coli strains to ertapenem,ampicillin,and piperacillin reached to 100.0%;the drug resistance rates of 9 Klebsiella pneumoniae strains to ampicillin,piperazillin,and ceftazidime were 100.0%;the drug resistance rates of 9 Enterobacter cloacae strains to ertapenem,ampicillin,piperacillin,and cefoperazone-sulbactam were 100.0%.The result of amplification of the drug resistance genes indicated that 29of the 31strains carried the drug resistance genes,among which the blaTEM-1gene,blaCTX-M-3gene,and blaTEM-1gene were the most common.CONCLUSION The carbapenemase-resistant Enterobacter causing infections in the children are highly resistant to multiple antibiotics,and most of the strains carry the drug resistance genes.It is necessary to standardize the use of antibiotics in clinical practice and reasonably use antibiotics based on the result of drug susceptibility testing so as to prevent the emergence of the carbapenemase-resistant Enterobacter.

关 键 词：儿童 碳青霉烯酶 耐药基因 肠杆菌科 

分 类 号：R378[医药卫生—病原生物学]