产超广谱β-内酰胺酶肺炎克雷伯菌的随机扩增多态性DNA分型研究  

Genotyping of ESBL Producing Klebsiella pneumoniae by RAPD

作　　者：彭少华[1] 李从荣[1] 蔡璇[1] 施金玲[1] 李红霞[1] 李艳[1] 

机构地区：[1]武汉大学人民医院,湖北武汉430060

出　　处：《中华医院感染学杂志》2002年第7期494-496,共3页Chinese Journal of Nosocomiology

基　　金：湖北省教育厅重点基金资助项目(编号99A062)

摘　　要：目的 对产超广谱β-内酰胺酶（ESBLs）肺炎克雷伯菌的耐药现状进行分析研究,对耐药株进行基因分型流行病学研究。方法 对临床分离的195株肺炎克雷伯菌进行ESBLs检测并采用微量稀释法测定MIC值,判断细菌的耐药性;对产ESBLs菌株以随机扩增多态性DNA分型法（RAPD）进行基因分型。结果 产ESBLs肺炎克雷伯菌占23％,其中51％来源于重症监护病房（ICU）;ESBLs阳性细菌对12种抗生素的耐药性远远高于ESBLs阴性菌;20株产ESBLs肺炎克雷伯菌分为11型。结论 本院神经外科SICU、呼吸科RICU存在产ESBLs肺炎克雷伯菌的流行;合理使用抗生素,加强重点病区的消毒隔离措施,是控制医院感染流行的重要措施;RAPD是从分子水平对耐药细菌进行流行病学研究的一种经济、快速、可靠的基因分型方法。OBJECTIVE To analyze the current resistance and to estimate the prevalence trend of exstended spectrum β-lactamase (ESBLs) producing K. pneumoniae. METHODS To detect the resistance of 195 strains ESBLs producing K. pneumoniae and ESBLs producing strains were genotyped by RAPD. RESULTS The ratio of ES-BLs-producing strains was 23%, from which 51% of were originated from ICU. Twenty strains of ESBLs-pro-ducing K. pneumoniae were divided into 11 types. CONCLUSIONS Chromosomal DNA analysis proved that some types of ESBLs-producing K. pneumoniae were epidemic in SICU and RICU. The reasonable use of antibiotics is an important measure for infection control. RAPD is an economic, quick and credible method for epidemic analysis.

关 键 词：肺炎克雷伯菌 超广谱Β-内酰胺酶 随机扩增多态性DNA分型 细菌耐药 医院感染 基因分型 

分 类 号：R378.996[医药卫生—病原生物学]