奇异变形杆菌β-内酰胺酶检测及耐药性分析  

Analysis of resistance to antibiotics and detection of inducible β-lactamase produced in Proteusmirabilis

作　　者：刘英其 

机构地区：[1]义乌市第二人民医院检验科,浙江义乌322002

出　　处：《中国微生态学杂志》2015年第10期1195-1198,共4页Chinese Journal of Microecology

摘　　要：目的了解奇异变形杆菌临床分离株产超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(AmpC)、金属酶(MBLs)、肺炎克雷伯杆菌碳青霉烯酶(KPC)情况,并分析其对18种常见抗菌药物的耐药性。方法 ESBLs、AmpC和MBLs采用三维试验检测,KPC采用改良Hodge试验进行检测,并以K-B法测定18种常见抗菌药物的耐药性。结果 302株奇异变形杆菌单产ESBLs 60株,检出率为19.87%;单产AmpC 40株,检出率为13.25%;KPC 3株,检出率为0.99%;所有菌株中未检出金属β-内酰胺酶(MBLs);同产ESBLs及AmpC 36株,检出率为11.92%;未发现其他双产酶菌株。奇异变形杆菌非产酶分离株对常用抗生素(呋喃妥因、复方新诺明除外)的耐药率均低于50.00%;奇异变形杆菌产酶分离株对亚胺培南、美罗培南培南的耐药率低于10.00%,与非产酶菌株相比,差异无统计学意义(P>0.05);对其余大部分抗生素的耐药率均明显高于非产酶菌株(P<0.05)。同产ESBLs+AmpC与耐亚胺培南奇异变形杆菌分离株呈多重耐药。结论我院奇异变形杆菌分离株产生ESBLs、AmpC及KPC,且对常用抗生素耐药性比较严重,建议临床医师根据实验室药敏试验结果,合理使用抗生素。Objective To learn the positive rate of Extended-spectrum β-Lactamases （ESBLs）, Cephalospori- nase （AmpC） and Klebsiella pneumoniae carbapenem （KPC） in Proteusmirabilis and its resistance rates to 18 kinds of common antimicrobial agents. Methods ESBLs, AmpC and MBLs were detected with three di- mensional test and the phenotype of KPC was detected by using the modified Hodge test with Ertapenem as the indicator. The resistance rates to eighteen common antibiotics were detected by K-B method. Results 60 （19. 8756） ESBLs producing strains, 40 （13.25%） AmpC producing strains and 3 （0. 9956） KPC produ- cing strains were detected while no metallo-β-lactamase （MBLs） producing strains were found. 36 strains （11. 9256） were both ESBLs and AmpC producers, and other double enzyme producing strains were not found. The resistance rates of non-enzyme producing Proteusmirabilis to common antibiotics were less than 50. 0056 except to Nitrofurantoin and Trimethoprim-sulfamethoxazole. The resistance rates of enzyme-pro- ducing strains to Imipenem and Meropenem were lower than 10.00 %, which was not statistically different from those of non-enzyme-producing strains （P〉0.05）, while the resistance rates to the other antibiotics were significantly higher than those of non-enzyme producing strains （P〈0.01）. The imipenem-resistant Proteusmirabilis strains producing both ESBLs and AmpC showed multidrug resistance. Conclusion The Proteusmirabilis isolates in our hospital produce ESBLs, AmpC and KPC and are highly resistant to common antibiotics. Clinicians should use antibiotics rationally based on the susceptibility test results to prevent the prevalence of drug resistant strains.

关 键 词：奇异变形杆菌 超广谱Β-内酰胺酶 头孢菌素酶 金属酶 肺炎克雷伯杆菌碳青霉烯酶 耐药性 

分 类 号：R440[医药卫生—诊断学]