肺炎克雷伯菌AmpC酶检测及抗生素选择  

Klebsiella Pneumoniae AmpC Enzyme Detection and Antibiotic Selection

作　　者：刘永瑞 张妍[1] 李秀英[1] LIU Yong-rui;Zhang Yan;LI Xiu-ying(Department of Respiratory,the First People's Hospital of Jining,Jining 272100,Shandong,China)

机构地区：[1]济宁市第一人民医院呼吸科

出　　处：《医学信息》2019年第19期122-123,126,共3页Journal of Medical Information

基　　金：山东省医药卫生科技发展计划项目(编号:2016WSA08005)

摘　　要：目的调查济宁市第一人民医院肺炎克雷伯菌质粒介导AmpC酶表型及其对常用抗生素的耐药性,为临床用药提供依据。方法收集2017年1月~7月济宁市第一人民医院临床分离的非重复肺炎克雷伯菌97株,应用头孢西丁纸片扩散法进行肺炎克雷伯菌AmpC酶表型初筛,对初筛阳性菌用多重PCR方法检测质粒介导AmpC酶基因,分析其耐药情况。结果97株肺炎克雷伯菌中共筛选出40株对头孢西丁不敏感菌株,经多重PCR扩增,有7株AmpC酶阳性,检出率为7.22%(7/97),均为DHA型。产质粒介导AmpC酶菌株仅对亚胺培南敏感(100.00%)。结论济宁市第一人民医院产质粒介导AmpC酶肺炎克雷伯菌发生率相对较低,以DHA型基因为主,治疗应首选碳青霉烯类抗菌药物。Objective To investigate the AmpC phenotype of Klebsiella pneumoniae mediated by Klebsiella pneumoniae in Jining First People's Hospital and its resistance to common antibiotics,and provide evidence for clinical use.Methods A total of 97 strains of non-repetitive Klebsiella pneumoniae isolated from the First People's Hospital of Jining City from January to July 2017 were collected.The phenycepin diffusion method was used to screen the AmpC enzyme phenotype of Klebsiella pneumoniae.The primary screening positive bacteria were detected by multiplex PCR method for plasmid-mediated AmpC enzyme gene,and the drug resistance was analyzed.Results A total of 40 strains of cefoxitin-insensitive strains were screened from 97 strains of Klebsiella pneumoniae.Seven strains of AmpC enzyme were positive by multiplex PCR,and the detection rate was 7.22%(7/97),all of which were DHA type.The plasmid-mediated AmpC enzyme strain was only sensitive to imipenem(100.00%).Conclusion The incidence of plasmid-mediated AmpC enzyme Klebsiella pneumoniae in the First People's Hospital of Jining City is relatively low.The DHA type gene is the main treatment.The carbapenem antibiotics should be the first choice for treatment.

关 键 词：肺炎克雷伯菌 质粒 AMPC酶 药敏结果 

分 类 号：R378.99[医药卫生—病原生物学]