摘要
目的调查粘质沙雷菌临床分离株β-内酰胺类耐药基因的携带情况,研究其对β-内酰胺类抗菌药物的耐药机制。方法采用Vitek2-Compact全自动微生物系统对临床分离菌进行鉴定,检出粘质沙雷菌287株,同时进行药敏试验,选出多重耐药粘质沙雷菌135株;采用双纸片确证试验对所有287株粘质沙雷菌进行ESBLs检测、三维试验法检测AmpC酶,采用PCR法对135株多重耐药粘质沙雷菌进行β-内酰胺类抗菌药物相关基因SHV、TEM、OXA、PER、VEB、GES、IMP、VIM、FOX、CTX、KPC、DHA、MOX和oprD2检测。结果粘质沙雷菌对氨苄西林、头孢曲松、头孢吡肟、头孢噻肟、氨曲南、庆大霉素、环丙沙星以及哌拉西林等临床常用抗菌药物的耐药率较高,耐药率均大于60%,对亚胺培南、美罗培南、舒普深的耐药率较低,耐药率均小于10%。在287株粘质沙雷菌中,共有32株产ESBLs,检出率为11.1%,产AmpC酶44株,检出率为15.3%,同时产ESBLs和AmpC酶细菌16株,占5.6%;PCR结果显示,在135株多重耐药的粘质沙雷菌中,检出含CTX-M基因菌株91株、TEM基因25株、SHV基因19株、DHA基因48株、KPC基因10株、MOX基因3株、OXA基因1株、oprD2基因7株。结论本地区粘质沙雷菌多重耐药现象较为严重,其耐药基因型主要为CTX-M型和DHA基因型。
Objective Survey Serratia marcescens clinical isolates β-lactam resistance genes carry case,study its resistance mechanisms on β-lactam antimicrobial.Methods Using Vitek 2 Compact automatic microbial analysis system identification of clinical isolates of Serratia marcescens,287 strains were detected,Susceptibility testing simultaneously selected 135 strains of multi-drug resistant Serratia marcescens.Using double disk confirmatory method for all 287 Serratia marcescens for ESBLs detection,three-dimensional test AmpC enzyme assay,using the PCR method to 135 multidrug resistant Serratia marcescens for β-lactam antibiotics related gene SHV,TEM,OXA,PER,VEB,GES,IMP,VIM,FOX,CTX,KPC,DHA,MOX and oprD2 detection.Results Serratia marcescens to ampicillin,ceftriaxone,cefepime,cefotaxime,aztreonam,gentamicin,ciprofloxacin and piperacillin antimicrobial resistance rate is higher,the resistance rate of more than 60 ％,to imipenem,meropenem,sulperazone drug resistance rate is low,the resistance rate of less than 10％.In 287 Serratia marcescens,a total of 32 producing ESBLs,the detection rate of 11.1％,44 strains producing AmpC,the detection rate of 15.3 ％,while producing ESBLs and AmpC bacteria 16,accounting for 5.6 ％.PCR results showed that in 135 multi-drug resistant Serratia marcescens,the CTX-M genes detected with strains 91,TEM gene 25,SHV gene 19,DHA gene 48,KPC gene 10,MOX gene 3,OXA gene 1,oprD2 gene 7.Conclusion The region Serratia marcescens multidrug resistance phenomenon is more serious,the resistance genotype mainly CTX-M and DHA genotype.
出处
《中国实验诊断学》
2014年第3期431-434,共4页
Chinese Journal of Laboratory Diagnosis
基金
青岛市公共领域科技支撑计划项目[2012-1-3-1-(18)-nsh]
关键词
粘质沙雷菌
耐药性
耐药基因
基因型
Serratia marcescens
Drug resistance
Resistance gene
Genotype
