肺炎克雷伯菌生物膜形成能力及其与多黏菌素B耐药相关性研究  

Study on the correlation between biofilm formation and polymyxin B resistance of Klebsiella pneumonia

作　　者：侯渊博 张亚培[2] 吴庆[3] 陈华乐[3] 李斌[3] 周铁丽[3] 曹建明[1] 

机构地区：[1]温州医科大学检验医学院与生命科学学院,温州325000 [2]浙江医院检验科,杭州310000 [3]温州医科大学附属第一医院医学检验中心,温州325000

出　　处：《中国抗生素杂志》2016年第6期473-477,共5页Chinese Journal of Antibiotics

基　　金：国家自然科学基金(No.81171614);浙江省卫生高层次创新人才培养工程项目(浙卫发No.[2012]241号)

摘　　要：目的 探究肺炎克雷伯菌生物膜形成能力及其与多黏菌素B耐药相关性.方法 收集温州医科大学附属第一医院临床分离的耐碳青霉烯类肺炎克雷伯菌（carbapenem-resistant Klebsiella pneumonia,CRKPs）共37株,琼脂稀释法检测亚胺培南（imipenem,IMP）、美罗培南（meropenem,MEP）、厄他培南（ertapenen,ETP）和多黏菌素B（polymyxin B,PB）对37株试验菌株的最低抑菌浓度（minimum inhibition concentrations,MICs）;96孔板结晶紫染色法检测37株试验菌株的生物膜A590值;检测37株试验菌株对PB的生物膜最低消除浓度（minimal biofilm elimination concentrations,MBECs）.结果 37株CRKPs对3种碳青霉烯类药物的敏感性都表现出不同程度的下降,对PB保持敏感,MIC为0.25～1 μg/mL,而MBEC为3～＞12μg/mL,相对于MIC值都表现为耐药;但是生物膜形成能力的强弱与MBEC值之间不存在线性相关性.结论 本次37株耐碳青霉烯肺炎克雷伯菌形成生物膜后可以增加对PB的耐药,但是生物膜形成能力的强弱与耐药程度无关.Objective To investigate the correlation between biofilm formation and polymyxin B resistance of Klebsiella pneumonia. Methods 37 strains of carbapenem-resistant Klebsiella pneumonia were collected from the First Affiliated Hospital of Wenzhou Medical University. The minimum inhibition concentrations（MICs） of imipenem, meropenem, ertapenem and polymyxin B for isolates were determined by agar dilution method. The biofilm formation assay of CRKPs were analysed by crystal violet staining assay. The minimal biofilm elimination concentrations（MBECs） of polymyxin B were also tested. Results 37 strains showed decrease susceptibility or low-level resistance to three carbapenems, but restored susceptible to PB. MICs of PB were between 0.25-1μg/mL designate to susceptible, but MBECs were between 3-〉12μg/mL designate to resistance corresponding to MICs. The results also showed that there was no correlation between MBECs and biofilm A590values. Conclusion The biofilm cells of Klebsiella pneumonia could surely improve resistant to polymyxin B when compared to planktonic cells, but between biofilm formation and antibiotic resistance, there was no correlation.

关 键 词：细菌生物膜 A590值 MBEC值 肺炎克雷伯菌 多黏菌素 耐药 

分 类 号：R178.1[医药卫生—妇幼卫生保健]