瑞安地区肺炎克雷伯菌ESBLs及AmpC β-内酰胺酶的基因分布与耐药特性的相关性研究  

The prevalence and distribution of ESBLs and AmpC-lactamase genes of Klebsiella pneumonia in Ruian

作　　者：涂斐佩 张新明 吴海鸥 

机构地区：[1]瑞安市中医院,瑞安325200

出　　处：《中国抗生素杂志》2015年第4期274-277,共4页Chinese Journal of Antibiotics

摘　　要：目的研究瑞安地区肺炎克雷伯菌ESBLs及Amp Cβ-内酰胺酶的基因分布与耐药相关性。方法收集2008年1月至2014年12月瑞安市地区临床分离的500株肺炎克雷伯菌,采用K-B法进行体外药敏试验,采用ESBLs确证试验和改良的头孢西叮三维试验确定产酶表型,采用聚合酶链式反应进行ESBLs酶及Amp Cβ-内酰胺酶基因的检测,采用聚合酶链式反应进行ESBLs酶及Amp Cβ-内酰胺酶基因的检测。结果 360株检测出ESBLs酶,其中ESBLs基因阳性316株,主要为SHV型基因;检出Amp Cβ-内酰胺酶28株,主要为DHA型基因;两种基因同时阳性者16株。除哌拉西林/三唑巴坦,单产Amp Cβ-内酰胺酶、ESBLs及两种基因同时阳性菌(SSBLs)对其他17种常用抗菌药物的耐药率均高于不产酶菌株。结论本地区肺炎克雷伯菌的ESBLs耐药基因检出率高,ESBLs阳性株耐药率明显高于ESBLs基因阴性株。Objective To investigate the genes distribution of ESBLs and AmpC b-lactamase of Klebsiella pneumoniae and the correlation of drug resistance. Methods 500 strains were collected from January 2008 to December 2014. All strains were tested by K-B method for durg resistance. The phenotypes of ESBLs and AmpC β-lactamases form Cefoxitin-resistant strains were detected by ESBLs confirmatory test and Cefoxitin-threedimensional test, respectively. PCR and DNA sequencing were undertaken to detect ESBLs and AmpC genes. Results 360 strains ESBLs were identified form 500 Klebsiella pneumoniae isolates, mainly for the SHV type gene; 28 strains were detected of AmpC, mainly for the DHA type gene; 16 stains both with ESBLs and AmpC genes. In addition to piperacillin/tazobactam, the strains with AmpC enzyme, ESBLs or both with two kinds of genes positive （SSBLs） resistant to the other 17 antibiotics were higher than those of non enzyme producing strains. Conclusion The ESBLs resistance gene detection rate was high in KlebsieIla pneumonia, The drug resistance of ESBLs gene positive stains was significant higher than that of negative strains.

关 键 词：肺炎克雷伯菌 ESBLS AMPC Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]