摘要
目的分析产酸克雷伯菌耐碳青霉烯类抗生素的分子机制。方法收集福建医科大学附属协和医院2011年8月~2012年8月临床分离非重复耐碳青霉烯类抗生素的产酸克雷伯菌菌株5株,检测厄他培南(ETP)、亚胺培南(IPM)及美罗培南(MEM)的最低抑菌浓度(MIC)筛查菌株;采用改良Hodge试验进行碳青霉烯酶表型鉴定、琼脂稀释法测其药敏;聚合酶链反应(PCR)扩增超广谱β-内酰胺酶(ESBLs)、碳青霉烯酶耐药基因;对检出碳青霉烯类基因的产酸克雷伯菌进行接合试验。结果 5株产酸克雷伯菌对17种抗菌药物中耐药率≥80%的有9种,分别为头孢西丁、头孢他啶、头孢噻肟、头孢吡肟、厄他培南、亚胺培南、庆大霉素、头孢哌酮/舒巴坦、氨曲南。对替加环素、美罗培南、多黏菌素B和哌拉西林/他唑巴坦的耐药性较低。改良Hodge试验检出4例产碳青霉烯酶。2株携带碳青霉烯类耐药基因(1株仅IMP-4阳性,1株KPC-2和IMP-8同时阳性),3株检出β-内酰胺酶基因。结论福建医科大学附属协和医院产酸克雷伯菌耐碳青霉烯类抗生素耐药机制可能为携带IMP及KPC基因,并且发现了产酸克雷伯菌同时携带两种碳青霉烯类耐药基因的现象。
Objective To investigate the resistance mechanism of Carbapenem-Resistant Klebsiella oxytoca. Methods Car- bapenem-Resistant Klebsiella oxytoca were collected from Fujian Medical University Union Hospital. The modified hodge test （MHT） was used for carbapenemase phenotype screening. The minimum inhibit concentration（MIC） was detected using agar dilution method for 17 drugs. PCR and DNA sequencing were used to detect common β-Lactamase genes and carbapene- mases genes. Conjugation experiments demonstrated the transferability of the carbapenem-resistant determinants. Results 5 Carbapenem-Resistant Klebsiella oxytoca of 4 isolates were positive detected by MHT. Minimum inhibit concentration was detected by using agar dilution method for 17 drugs. More than 80%isolates were resistance to nine drugs. 2 isolates conju- gated successfully of 5 Carbapenem-Resistant Klebsiella oxytoca Isolates. There were 2 isolates included carbapenemases gene （1 isolates were only IMP producers, 1 isolate contained the IMP and KPC）, 3 isolates produce ESBLs gene. Conclution The due to CRE strains isolated from Fujian Medical University Union Hospital may be metallo-enzyme carbapenemase and KPC gene. And the isolate that produce two Carbapenem Resistant gene had been found in this hospital.
出处
《现代检验医学杂志》
CAS
2017年第1期19-21,共3页
Journal of Modern Laboratory Medicine
基金
国家自然科学基金(81201328
81171656)
福建省高校杰青项目(JA13134)
福建省卫计委中青年骨干人才培养项目(2015-ZQW-ZD-15)
