手外科患者手术切口感染产AmpC酶革兰阴性杆菌耐药基因型检测与分析  

Test and analysis in patients with surgery incision infection AmpC enzyme producing Gram-negative bacilli resistant genotype

作　　者：程海荷 金海萍[2] 边保华[3] CHENG Hai -he;JIN Hai -ping;BIAN Bao-hua(Surgery,Orthopedic Hospital of Taizhou,Wenling,Zhejiang 317500,China)

机构地区：[1]台州骨伤医院手外科,浙江温岭317500 [2]浙江省台州医院,浙江临海317000 [3]台州学院医学院检验系,浙江台州318000

出　　处：《中国卫生检验杂志》2019年第2期183-185,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过分析手术切口感染的革兰阴性杆菌产AmpC酶的耐药表型与基因型,探讨其耐药特征和流行趋势。方法采用VITEK 2 Compact全自动微生物分析仪对菌株进行鉴定;产AmpC酶菌株筛选按CLSI推荐的头孢西丁纸片扩散法;产AmpC酶菌株确证采用三维试验;采用多重PCR和DNA测序检测耐药菌株AmpC酶耐药基因型。结果 117株革兰阴性杆菌经头孢西丁敏感试验筛选出疑产AmpC酶菌株25株,经三维试验确证产AmpC酶菌株24株,并经PCR检测有22株菌株在405 bp处出现阳性条带,2株在462 bp处出现阳性条带,再经DNA测序分析前者为AmpC酶DHA-1型基因型;后者为AmpC酶CIT型基因型。结论手外科患者手术切口感染检出的革兰阴性杆菌产AmpC酶检出率较高,DHA-1型为主要流行基因型。Objective To investigate the drug resistance and epidemic trend by analyzing the drug resistance phenotype and genotypes of AmpC producing Gram negative bacteria from surgical incision infection.Methods Bacteria were identified with VITEK 2 Compact.Strains producing AmpC enzyme was screened by cefoxitin disk diffusion method recommended by CLSI and confirmed by three dimensional test,and multiplex polymerase chain reaction(PCR)and DNA sequencing were used to analyze the resistance genotype of drug resistance strains producing AmpC enzyme.Results Totally,25 strains producing AmpC enzyme were screened from 117 strains of Gram-negative bacillus through cefoxitin sensitive test,of which 24 strains were confirmed by three-dimensional test;by PCR detection,22 strains were positive at 405bp stripe and 2 strains were positive at 462bp stripe.Then through DNA sequencing analysis,the former type was AmpC enzyme DHA-1 genotype and the latter type was AmpC enzyme CIT genotype.Conclusion The detection rate of Gram-negative bacillus producing AmpC enzyme is high in surgical patients and the popular genotype is given priority to DHA-1.

关 键 词：手外科 切口感染 革兰阴性杆菌 AMPC酶 基因型 

分 类 号：R446.5[医药卫生—诊断学]