53株耐碳青霉烯类药物粘质沙雷菌的耐药表型分析  

The Phenotypic Analysis of 53 Strains of Serratia Marcescens Resistant to Carbapenems

作　　者：张燕[1] 周万青 李佳 郑洁 高硕 张之烽 孟玲宁 曹小利 沈瀚 张葵[1] ZHANG Yan;ZHOU Wanqing;LI Jia(Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008)

机构地区：[1]南京医科大学鼓楼临床医学院,210008

出　　处：《临床输血与检验》2021年第1期87-90,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的研究耐碳青霉烯药物粘质沙雷菌的耐药表型。方法收集南京大学医学院附属鼓楼医院2018年6月~2019年9月临床分离的235株非重复粘质沙雷菌,采用Vitek 2 Compact配套GN13药敏板卡和纸片扩散法进行药物敏感性检测;采用改良碳青霉烯酶灭活试验(mCIM)和EDTA-改良碳青霉烯酶灭活试验(eCIM)对碳青霉烯酶表型进行筛选;采用PCR及测序分析检测碳青霉烯酶基因携带情况。结果235株粘质沙雷菌中检出同时对美罗培南和亚胺培南耐药菌株53株(22.6%)。53株碳青霉烯类耐药菌株中对头孢他啶敏感和中介分别为23株(43.4%)和21株(39.6%),对头孢曲松、氨曲南、环丙沙星、左氧氟沙星的耐药率均大于98%,对阿米卡星、复方新诺明的耐药率分别为1.7%和1.6%。mCIM均阳性,eCIM阳性3株。53株耐药菌株中检出blaKPC-2基因51株,检出blaNDM-1基因1株,同时携带blaKPC-2和blaNDM-1基因1株,未检出blaIMI、blaOXA48、blaFOX、blaIMP和blaVIM基因。结论本院耐碳青霉烯粘质沙雷菌检出率较高,blaKPC-2基因是介导本院粘质沙雷菌对碳青霉烯类药物耐药的主要流行基因型。Objective To investigate the drug resistance phenotype of carbapenems resistance in Serratia marcescens strains.Methods From June 2018 to September 2019,235 non-repetitive strains of Serratia marcescens were isolated from patients in Gulou Hospital affiliated to Medical College of Nanjing University.The drug sensitivity was detected by Vitek 2 Compact matched GN13 drug sensitivity board and disk diffusion method.The carbapenem phenotype was screened by modified carbapenem inactivation test(mCIM)and EDTA-modified carbapenem inactivation test(eCIM).The carrying status of carbapenem gene was detected by PCR and sequencing analysis.Results Among 235 strains of Serratia marcescens,53 strains(22.6%)were resistant to both meropenem and imipenem.Among the 53 carbapenem resistant strains,23(43.4%)were sensitive and 21(39.6%)were intermediate to ceftazidine.The resistance rates to ceftriaxone,amtronan,ciprofloxacin and levofloxacin were more than 98%,and the resistance rates to amikacin and cotrimoxacin were 1.7%and 1.6%,respectively.All of them were positive for mCIM and 3 strains were positive for eCIM.Among the 53 strains,51 strains had blaKPC-2 gene,1 strain had blaNDM-1 gene,1 strain carried both blaKPC-2 and blaNDM-1 genes,and no blaIMI,blaOXA48,blaFOX,blaIMP and blaVIM genes were detected.Conclusion The detection rate of carbapenem-resistant Serratia marcescens was high in our hospital.Blakpc-2 gene is the main prevalent genotype in carbapenem-resistance in Serratia marcescens strains.

关 键 词：粘质沙雷菌 碳青霉烯类 耐药性 

分 类 号：R446.5[医药卫生—诊断学]