两株携带NDM-1型金属β-内酰胺酶阴沟肠杆菌的临床特征研究  

Clinical characteristics of two strains of Enterobacter cloacae harboring NDM-1 carbapenemase

作　　者：曹丽军[1] 李慧卿[1] 耿凤珍[1] 史峥[1] 时东彦[2] 

机构地区：[1]河北大学附属医院检验科,河北保定0710000 [2]河北医科大学第二医院检验科,河北石家庄050000

出　　处：《中华医院感染学杂志》2015年第23期5305-5307,5325,共4页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究基金资助项目(20130185)

摘　　要：目的调查分析两株耐碳青霉烯类阴沟肠杆菌临床资料,探讨NDM-1产生的根源及预防和控制的措施。方法收集2012年7月医院培养两株耐碳青霉烯类阴沟肠杆菌,采用微量肉汤稀释法进行药敏试验,改良Hodge试验和金属酶试验检测产酶类型,聚合酶链反应(PCR)检测耐药基因并进行测序。结果两株阴沟肠杆菌对亚胺培南和美罗培南的MIC均>8μg/ml,改良Hodge试验阳性,金属酶表型初筛试验阳性,经基因扩增并测序后,与Genebank比对,表明与NDM-1基因有99%的相似性,临床资料显示,该两株菌有一定的同源性,可能有共同的传播途径。结论对碳青霉烯类抗菌药物高度耐药的阴沟肠杆菌有传播的趋势,通过消毒等措施能得到控制。OBJECTIVE To investigate the clinical data of two strains of carbapenem-resistant Enterobacter cloacae and explore the root causes of production of NDM-1 so as to put forward the prevention measures. METHODS To- tally two strains of carbapenem-resistant E. cloacae were cultured in the hospital in Jul, 2012. The drug suscepti- bility testing was performed by using broth dilution method, the isolates were screened for phenotype with the use of modified Hodge test and metalloenzyme test, and the drug resistant genes were sequenced by means of polymer- ase-chain-reaction （PCR）. RESULTS The MICs of the two E. cloacae isolates to imipenem and meropenem were more than 8 μg/ml, the modified Hodge test showed positive, and the preliminary screening test was positive for the phonotype of metalloenzyme. The amplification and sequencing of the genes indicated that by contrast to Gene- bank, the β-lactamase gene was 99% similarity to NDM-1; the clinical data showed that the two strains had cer- tain homology and may share the common transmission route. CONCLUSION The E. cloacae strains that are highly resistant to carbapenems tend to spread, which can be controlled through disinfection.

关 键 词：阴沟肠杆菌 碳青霉烯类 抗菌药物 新德里金属-β-内酰胺酶-1 

分 类 号：R378[医药卫生—病原生物学]