阴沟肠杆菌耐药性及氨基糖苷类修饰酶基因型的研究  

Study on the antimicrobial resistance of Enterobacter cloacae and the genotype of AMEs

作　　者：梁彩倩[1] 杨晓燕[1] 邢帮荣[1] 符永玫[1] 张永标[1] 

机构地区：[1]中山大学附属第三医院急诊科,广东广州510630

出　　处：《中国卫生检验杂志》2015年第13期2233-2235,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的了解阴沟肠杆菌耐药性以及氨基糖苷类修饰酶（AMEs）基因型的流行状况。方法采用K—B纸片法测定21种抗菌药物的敏感性；应用PCR方法扩增7种AMEs基因，PCR阳性产物进行电泳分析和测序。结果124株阴沟肠杆菌对亚胺培南最敏感，耐药率为3．2％；对哌拉西林／他唑巴坦及4种氨基糖苷类药物阿米卡星、庆大霉素、妥布霉素、奈替米星的耐药率分别为24．2％、19．4％、46．8％、41．9％、43．5％；对氟喹诺酮类药物的耐药率为30．6％～41．9％；其余13种菌的耐药率均〉46．8％。68株阴沟肠杆菌（54．8％）检出AMEs基因；aac（3）-Ⅱ、aac（6’）-Ib、ant（3”）-I和ant（2”）-I基因的检出率分别为22．6％、46．8％、35．5％和4．8％，未检出aac（3）-I、（tac（6’）-Ⅱ和aph（3’）-Ⅵ基因。结论阴沟肠杆菌呈多重耐药表型特征，对氨基糖苷类的耐药性与AMEs密切相关，流行的基因型主要为age（6’）-Ib＋ant（3”）-I和aac（3）-Ⅱ＋aac（6’）-Ib。Objective To investigate the antimicrobial resistance of Enterobacter cloacae and the prevelance genotypes of aminoglycoside modifying enzymes（AMEs）. Methods The susceptibility of 21 antimicrbbial drugs were tested by Kirby - Bauer diffusions method. PCR method was used to amplify 7 kinds of AMEs genes, and the PCR positive products were analyzed and sequenced by electrophoresis. Results The 124 strains of Enterobacter cloacae were most sensitive to imipenem with the resistance rate of 3.2% , and the resistant rates to piperacillin/tazobactam, amikacin, gentamicin, tobramycin and netilmicin were 24.2%, 19.4%, 46.8%, 41.9% and 43.5%, respectively. The resistance rates to quinolones was among 30.6% -41.9%. The resistance rates to other antimicrobial agents were over 46.8%. AMEs genes were detected in 68 Enterobacter cloacae isolates. Except for the aac（3） - Ⅰ, aac（6＇）- lland aph（3＇） -Ⅵ genes, aac（3） - Ⅱ, aac（6＇） -Ib, ant（3＂） - Ⅰ and ant （2＂） - Ⅰ genes were detected with the detection rates of 22.6%, 46.8%, 35.5% and 4.8%, respectively. Conclusion The Enterobacter cloacae shows multiple resistance, and the resistance to aminoglycosides was closely related to AMEs. The prevalent principal genotypes were aac（6＇） -Ib ＋ ant（3＂） - Ⅰ and aac（3） - Ⅱ ＋ aac（6＇） -Ib in these isolates.

关 键 词：阴沟肠杆菌 氨基糖苷类修饰酶 耐药性 基因型 

分 类 号：R446.5[医药卫生—诊断学]