阴沟肠杆菌耐药性分析及NDM-1基因检测  

Drug resistance of Enterobacter cloacae and detection of NDM-1 gene

作　　者：刘鹏飞[1] 陈佑明[1] 孙恒彪[1] 马晓霞[2] 张婧[1] 

机构地区：[1]南方医科大学第三附属医院检验科,广东广州510630 [2]南方医科大学遗传学教研室,广东广州510515

出　　处：《中华医院感染学杂志》2014年第21期5204-5206,共3页Chinese Journal of Nosocomiology

基　　金：广东省教育部产学研结合基金资助项目(2011A090200047)

摘　　要：目的探讨阴沟肠杆菌的耐药性以及对亚胺培南耐药菌株进行新德里金属β-内酰胺酶1型(NDM-1)基因检测分析,为临床治疗阴沟肠杆菌感染合理用药提供试验依据。方法试验菌株分离自2011年7月-2012年6月的临床标本,采用西门子Microscan Walkway 40plus全自动微生物分析系统对菌株进行鉴定及药敏检测,应用WHONET5.4对数据进行分析统计;聚合酶链反应(PCR)特异性扩增NDM-1基因,并对扩增产物进行测序和BLAST分析。结果共分离得到35株阴沟肠杆菌,对亚胺培南敏感性最高,敏感率为91.4%,但也出现3株耐药菌株,其次为阿米卡星;对第一代头孢菌素头孢唑林及广谱青霉素的耐药率>90.0%,对其他抗菌药耐药率>40.0%;3株亚胺培南耐药菌株NDM-1检测均为阳性,且同源性为100.0%。结论多药耐药阴沟肠杆菌及产NDM-1阴沟肠杆菌的出现,造成耐药形势日益严峻,需要加强监测力度。OBJECTIVE To explore the drug resistance of Enterobacter cloacae and detect the type 1 New Delhi met-alloβ-lactamase （NDM-1） in the imipenem-resistant strains so as to provide experimental bases for reasonable use of antibiotics for clinical treatment of E .cloacae infection .METHODS The study strains were isolated from the clinical specimens that were collected from Jul 2011 to Jun 2012 ,then the identification of the strains and the drug susceptibility testing were performed by using Siemens Microscan Walkway 40 plus automatic microorganism ana-lyzer ,the data were statistically analyzed by means of WHONET 5 .4 software ,the NDM-1 gene was amplified by using polymerase-chain-reaction （PCR ） , and the amplified products were sequenced for BLAST analysis . RESULTS A total of 35 strains of E .cloacae have been isolated ,the drug susceptibility rate to imipenem was the highest （91 .4% ） ,however ,3 drug-resistant isolates emerged ,followed by amikacin .The drug resistance rates to the first generation cephalosporins cefazolin and broad spectrum penicillin were more than 90 .0% ,and the drug resistance rates to other antibiotics were more than 40 .0% .All the 3 imipenem-resistant isolates were detected positive for the NDM-1 ,with the homology of 100 .0% .CONCLUSION The multidrug-resistant E .cloacae and NDM-1-producing E .cloacae strains have emerged ,which leads to the increasingly severe drug resistance ,thus , the monitoring should be strengthened .

关 键 词：阴沟肠杆菌 金属β-内酰胺酶1型基因 耐药 

分 类 号：R378[医药卫生—病原生物学]