摘要
目的了解黏质沙雷菌耐药性及对亚胺培南耐药机制。方法收集安徽省蚌埠医学院第一附属医院2013年1月-2014年12月临床分离的152株黏质沙雷菌,纸片扩散法和仪器法测定菌株对抗菌药物的耐药性。对筛选出的亚胺培南耐药黏质沙雷菌,采用改良Hodge试验和EDTA协同试验进行碳青霉烯酶表型检测,琼脂稀释法检测加入外排泵抑制剂MC207110前后亚胺培南MIC值的变化。聚合酶链反应(PCR)检测碳青霉烯酶、AmpC酶及外膜蛋白基因的携带情况。结果 152株黏质沙雷菌中87株对亚胺培南耐药,亚胺培南耐药菌株中12株改良Hodge试验阳性,9株EDTA协同试验阳性。46株加入外排泵抑制剂MC207110后亚胺培南MIC降低为原来的1/4~1/64;检出KPC耐药基因5株,IMP耐药基因8株,DHA耐药基因6株,外膜蛋白缺失16株。结论该院临床分离的黏质沙雷菌耐药情况严重,主要耐药基因型为KPC、IMP和DHA型。外膜蛋白缺失以及外排泵可能也是介导耐药的主要原因。
Objective To investigate the profile and mechanism of imipenem resistance in the clinical isolates of Serratia marcescens. Methods A total of 152 strains ofS. marcescens were isolated from January 2013 to December 2014. Disk diffusion method and automated systems were used to determine the susceptibility of the isolates. The modified Hodge test and EDTA synergy test were employed to test carbapenemase phenotype. Agar dilution method in combination with efflux pump inhibitor MC207110 was used to observe the change of imipenem MIC values. The genes encoding carbapenemase, AmpC beta-lactamase and outer membrane protein were detected by polymerase chain reaction. Results Imipenem resistance was identified in 87 of the 152 strains of S. marcescens. Modified Hodge test was positive for 12 of the 87 imipenem-resistant S. marcescens strains. EDTA synergy test was positive for 9 of the strains. Imipenem MIC was reduced to 1/4 to 1/64 in 46 strains by agar dilution method in presence of efflux pump inhibitor MC207110. Five strains were positive for KPC genes, 8 strains positive for IMP gene, and 6 strains positive for DHA gene. Loss of outer membrane protein was found in 16 strains by PCR. Conclusions Imipenem-resistant strains of S. marcescens are prevalent in our hospital. KPC, IMP, DHA genes, and loss of outer membrane proteins and efflux pumps may all contribute to imipenem resistance in S. marcescens isolates.
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2017年第2期187-191,共5页
Chinese Journal of Infection and Chemotherapy
基金
安徽省高校自然科学研究一般项目(N O.KJ2015B011by)
关键词
黏质沙雷菌
亚胺培南
耐药
Serratia marcescens
imipenem
antimicrobial resistance
