耐碳青霉烯类肠杆菌属细菌的耐药基因分型及同源性分析  

Typing and homology of drug resistance genes of carbapenem-resistant Enterobacteriaceae

作　　者：王洪刚[1] 孙希彩[1] 

机构地区：[1]潍坊市人民医院

出　　处：《实用医学杂志》2017年第19期3295-3298,共4页The Journal of Practical Medicine

基　　金：潍坊市科学技术发展计划项目(编号:2014WS019)

摘　　要：目的了解分离自我院住院患者的耐碳青霉烯类肠杆菌属细菌的耐药基因型及其同源性,为临床治疗提供理论依据。方法用Vitek-2 compact检测细菌对临床常用抗菌药物的药物敏感性;用PCR方法检测30株耐碳青霉烯类肠杆菌的6种耐药基因bla KPC、bla NDM-1、bla IMI-1、bla GES、bla SME和bla SHV。以Eric-PCR对5株bla NDM-1阳性者进行同源性检测。结果碳青霉烯类耐药肠杆菌属细菌30株,其中阴沟肠杆菌17株,产气肠杆菌10株,坂崎肠杆菌2株,生癌肠杆菌1株。检出的阳性基因分别为bla SHV 6株(20.0%)、bla NDM-1 5株(16.7%)、bla KPC 2株(6.7%)和bla GES 1株(3.3%)。5株bla NDM-1阳性菌株可以分为3个型。结论本次实验检测出的耐碳青霉烯类肠杆菌属,其耐药基因主要为bla SHV,其次为bla NDM-1,另有少部分bla KPC和bla GES。检测基因可能存在病房和医院内的克隆传播。Objective To investigate the genotype and its homology of carbapenem-resistant Enterobacter （CRE） isolated from hospitalized patients and to provide theoretical basis for clinical treatment. Methods Drug sensitivity of bacteria to antibiotics widely used in clinic was detected with a VITEK-2 COMPACT fully automated microbiological system. Resistance genes including blaKPC, blaNDM-1, blaIMI-1, blaGES, blaSME and blaSHV were detected by polymerase chain reaction （PCR） assay. Results Thirty carbapenem-resistanee strains were col- lected, including e.cloacae （17 strains） , e. Aerogenes （10 strains） , e. Sakazakii （2strains） and e. Cancerogenus （lstrain）. Positive genes included blaSHV （20.0%） , blaNDM-1 （ 16.7% ） , blaKPC （6.7%） , blaGES （3.3%） , blalMI-t （0） and blaSME （0）. Five strains which harbored blaNDM-1 were isolated into 3types. Conclusions The most prevalence resistance genes among the strains are blaSHV, followed by blaNDM-1 and other resistance genes at difference levels. There is potentially clonal spread of the resistance genes in the same room or in the whole hospital.

关 键 词：碳青霉烯类耐药 肠杆菌属 耐药基因 同源性 

分 类 号：R446.5[医药卫生—诊断学]