大肠埃希菌对碳青霉烯类抗生素的耐药机制研究  

The research of resistance mechanism on carbapenems of Escherichia coli

作　　者：卢玲玲 郑国军 涂斐佩 吴海鸥 

机构地区：[1]瑞安市中医院检验科,瑞安325200 [2]瑞安市人民医院检验科,瑞安325200

出　　处：《中国抗生素杂志》2016年第4期296-300,共5页Chinese Journal of Antibiotics

基　　金：医院感染性大肠埃希菌耐药回顾及对碳青霉烯类抗生素耐药机制研究(No.2015B42)

摘　　要：目的研究多重耐药大肠埃希菌碳青霉烯酶基因分布与耐药相关性。方法回顾性分析2010年1月至2014年12月期间本地区大肠埃希菌耐药现状,收集11株耐碳青霉烯类大肠埃希菌。对11株耐碳青霉烯类大肠埃希菌进行ESBLs检测,改良Hodge实验,金属β-内酰胺酶检测(EDTA-协同试验),三维试验检测Amp C酶;应用PCR技术进行碳青霉烯酶相关耐药基因检测,应用PFGE(脉冲场凝胶电泳)阐述菌株之间耐药传播及亲缘关系。结果我院产ESBLs大肠埃希菌检出率高,为57.5%。耐碳青霉烯类大肠埃希菌在2014年产ESBLs菌株中检出率达4.6%。11株耐碳青霉烯类大肠埃希菌中ESBLs阳性11株(100.0%),4株(36.3%)检出碳青霉烯酶,6株(54.5%)产Amp C酶,未见EDT A协同试验阳性;11株实验菌中PCR扩增结果示:blaKPC6株,测序为blaKPC-2,未检出B类,C类,D类β-内酰胺酶基因;分为3个克隆群。结论我院产ESBLs大肠埃希菌检出率高,多重耐药性严重,以blaKPC-2为主,本地区多重耐药大肠埃希菌克隆群主要分为2个群。Objective To investigate the genes distribution of carbapenemases of Escherichia coli and the correlation of drug resistance. Methods Retrospectively analyzed between January 2010 and December 2014. 11 strains were collected resistant to detect carbapenemases, then we applied with ESBLs test, modified Hodge experiment, metal beta lactamase detection （EDTA coordination test）, three-dimensional test AmpC enzyme; PCR technology for carbapenemases, pulsed field gel electrophoresis （PFGE） analysis of Escherichia coli to state that the drug resistance prevalence and genetic relationship. Results The detection rate of ESBLs was high（57.5%）, 4 strains （36.3%） produce carbapenemases, 6 strains （54.5%） with AmpC enzyme production strains, no metal beta lactamase was detected; 11 experimental strains in the PCR showed： blaKpC were 6 strains, the class B, C, D class beta lactamase gene was not checked out ; 11 strains were divided into three clone. Conclusion The ESBLs resistance gene detection rate was high in Escherichia coli, the multiple drug resistance of Escherichia coli was serious, and most were bla KPC-2, there were three clone.

关 键 词：大肠埃希菌 碳青霉烯酶 耐药性 

分 类 号：R978.1[医药卫生—药品]