某医院72株阴沟肠杆菌临床菌株分子型别与耐药特征分析  

Molecular characteristics and antibiotic resistance of 72 clinical strains of Enterobacter cloacae isolated in a hospital

作　　者：王怡倩[1] 付宝庆[2] 熊衍文[1] 叶长芸[1] Wang Yiqian;Fu Baoqing;Xiong Yanwen;Ye Changyun(State Key Laboratory. of Communicable Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;Department of Clinical Laboratory, Daqing Oilfield General Hospital, Daqing 163000, Heilongjiang, China)

机构地区：[1]中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室,北京102206 [2]大庆油田总医院检验科,黑龙江大庆163000

出　　处：《疾病监测》2018年第5期428-432,共5页Disease Surveillance

基　　金：国家科技重大专项(No.2013ZX10004-101)~~

摘　　要：目的分析72株阴沟肠杆菌临床菌株分子型别和耐药特征,为流行病学及临床研究提供参考依据。方法通过热休克蛋白基因和肽指纹图谱进行分子分型;采用琼脂药敏纸片法分析耐药表型;利用PCR扩增法对20个耐药基因进行检测;运用SAS软件对数据进行统计学分析。结果 72株阴沟肠杆菌临床菌株分为2个分支9个基因群,以分支1(基因群Ⅲ、Ⅵ和Ⅷ)菌株为主(50株,69.4%)。临床菌株对一至三代头孢、氨苄西林/舒巴坦具有较高的耐药率,对另外9种抗生素较为敏感。共检测到8个耐药基因(mir-act、dha、shv、tem、ctx-M、qnr A、qnr B和qnr S)。通过组内统计学分析发现,各型别菌株的临床分布、耐药率和耐药基因携带率不完全相同,差异有统计学意义。结论通过两种分型方法,阴沟肠杆菌临床菌株中存在优势型别,不同型别的菌株在耐药率和耐药基因携带率上存在差异。Objective To investigate the association between molecular characteristics and antibiotics resistance in clinicalisolates ofEnterobacter cloacae.Methods A total of 72 isolates ofE. cloacaefrom a hospital were typed according tohsp 60 gene sequence and peptide mass fingerprinting. The susceptibilities of the isolates to 14 antibiotics were tested with agar dilutionmethod. Twenty antibiotic resistance related genes were analyzed by using PCR and sequenced.Results Based onhsp60 genotype and peptide mass fingerprinting analysis,72 E. cloacaestrains could be divided into 2 clades and 9 gene clusters,clade 1（gene cluster：Ⅲ,Ⅵ and Ⅷ）strains were predominant in all the clinical isolates（50 strains,69.4%）. Antibioticsusceptibility test showed that the isolates were resistant to cefazolin,cefuroxime,ceftriaxone,ceftazidime,ampicillin/sulbactam;but sensitive to cefepime,piperacillin/tazobactam,aminoglycoside and quinolone. Eight antibiotics resistance genes（mir-act,dha,shv,tem.ctx-M,qnr A,qnr Bandqnr S）were detected.Conclusion Predominant genotype was detected inthe clinical isolates ofE. cloacaewith two subtyping methods. There were significance differences in clinical distribution andantibiotic resistance among theE. cloacaestrains with different genotypes.

关 键 词：分子型别 药敏试验 耐药基因 

分 类 号：R378.2[医药卫生—病原生物学]