诺卡菌对β-内酰胺类药物耐药性及与其耐药相关基因关系研究  

Study on the resistance of Nocardia toβ-lactam drugs and its resistance-related genes

作　　者：程振娜 李刚 赵梅 周晓燕 陶佳 郭睿 贾伟 Cheng Zhen-na;Li Gang;Zhao Mei;Zhou Xiao-yan;Tao Jia;Guo Rui;Jia Wei(Shandong Medical College,Linyi 276000;Center of Medical Laboratory,the General Hospital of Ningxia Medical University,Yinchuan 750004;Ningxia Key Laboratory of Clinical and Pathogenic Microbiology,Yinchuan 750004;Clinical Laboratory Medicine in Clinical College,Ningxia Medical University,Yinchuan 750004)

机构地区：[1]山东医学高等专科学校,临沂276000 [2]宁夏医科大学总医院医学实验中心,银川750004 [3]宁夏临床病原微生物重点实验室,银川750004 [4]宁夏医科大学临床医学院医学检验学系,银川750004

出　　处：《中国抗生素杂志》2021年第11期1054-1058,共5页Chinese Journal of Antibiotics

基　　金：宁夏回族自治区重点研发计划重大(重点)项目(No.2018BFG02008);临沂市科技创新发展计划项目(No.202020067)。

摘　　要：目的了解诺卡菌临床分离株对β-内酰胺类抗生素敏感性及其与相关耐药基因的关系,为临床治疗提供理论依据。方法选取宁夏医科大学总医院医学实验中心分离的诺卡菌临床菌株,以微量肉汤稀释法检测其对β-内酰胺类药物阿莫西林/克拉维酸、头孢曲松、亚胺培南、头孢吡肟、头孢噻肟的敏感性,以PCR法检测β-内酰胺类药物相关耐药基因blaZ、bla_(TEM-1)、bla_(VIM-2)。结果19株诺卡菌中,药敏结果显示其对头孢吡肟耐药最多,其次为头孢曲松和头孢噻肟。blaZ基因在1株鼻疽诺卡菌中检出,bla_(TEM-1)基因在2株盖尔森基兴诺卡菌中检出,未检出bla_(VIM-2)基因。结论诺卡菌对β-内酰胺类药物仍具有较高的敏感性,其耐药性与blaZ、bla_(TEM-1)、bla_(VIM-2)基因无直接相关性,可能存在另外的耐药基因。Objective To understand the sensitivity of clinical isolates of Nocardia toβ-lactam antibiotics and its relationship with drug resistance related genes,and provide a theoretical basis for clinical treatment.Methods The clinical strains of Nocardia were isolated from the Clinical Laboratory Center of General Hospital of Ningxia Medical University.Drug sensitivity toβ-lactam antibiotics such as amoxicillin/clavulanic acid,ceftriaxone,imipenem,cefepime,and cefotaxime were measured using the micro-broth dilution method.Theβ-lactam-related drug resistance genes of blaZ,bla_(TEM-1),and bla_(VIM-2)were detected by PCR.Results Among the 19 Nocardia strains,the drug sensitivity results showed that the resistance rate to cefepime was the highest,followed by ceftriaxone and cefotaxime.The blaZ gene was detected in one strain of Nocardia farcinica,the bla_(TEM-1)gene was detected in two strains of Nocardia cyriacigeorgica,and no bla_(VIM-2)gene was detected.Conclusion Nocardia is still highly sensitive toβ-lactam drugs,and its drug resistance is not directly related to blaZ,bla_(TEM-1),and bla_(VIM-2)genes.There may be additional drug resistance genes.

关 键 词：诺卡菌 Β-内酰胺类药物 耐药基因 

分 类 号：R978.1[医药卫生—药品]