摘要
目的:了解本地区泌尿系统感染产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌耐药特征及其基因型分布。方法:收集广州地区13家医院2001年7月～2003年8月间临床分离的尿培养阳性肺炎克雷伯菌130株,采用NCCLs规定的ESBLs初筛和确证试验方法检测ESBLs,用K-B琼脂扩散法进行药物敏感试验,并应用聚合酶链反应(PCR)方法对所分离的产ESBLs菌株进行SHV、CTX-M基因型检测。结果:产ESBLs肺炎克雷伯菌检出率为41.5%(54株),其中66.7%(36株)携带CTX-M基因,53.7%(29株)携带SHV型基因,并有20.4%(11株)同时携带CTX-M基因和SHV型基因。产酶株的耐药率明显高于非产酶株,产ESBLs细菌对青霉素类、环丙沙星及头孢菌素类耐药率较高(高达75.9～99.7%),加酶抑制剂克拉维酸或他唑巴坦后耐药率有明显下降。结论:广州地区泌尿系统感染的产ESBLs肺炎克雷伯菌具有多重耐药的特点,其中CTX-M型是流行的基因型。
Objective ：To study the resistant phenotype and genotype of extended spectrumβ-lactamase （ESBLs） produced in Klebsiella pneumoniae isolated from urinary infections in Guangzhou.Methods：Organisms of clinical infection were identified by automatic microbial system （Vitek）and the bacterial susceptibility was tested by Kirby-Bauer （K-B）method as described in NCCLS.ESBLs was detected by disk diffusion confirmatory test and CTX-M （or SHV specific PCR were used to determine the genotype of ESBLs. Results： 41.5% of Klebsiella pneumoniae produced ESBLs.36 of the 54 ESBLs producing strains（66.7%） expressed CTX-M β-lactamase and 29 of the 54 ESBLs producing strains（53.7%） expressed SHVβ-lactamase.The resistant rates of ESBLs-producing isolates against penicillins, ciprofloxacin and the third generation cephalosporins were about 75.9-99.7%. When combined with the laetamase inhibitors, tazobactam and clavulanic acid,the resistant rates were decreased obviously.Conclusion：Klebsiella pneumoniae produced ESBLs is multi- resistance. This study showes that CTX-M-type is predominant genotypes of ESBL in urinary infections in Guangzhou Area.
出处
《现代医药卫生》
2009年第13期1923-1924,共2页
Journal of Modern Medicine & Health
基金
广州市重点攻关科技项目(编号:2000-Z-027-01-2-4)
关键词
肺炎克雷伯菌
超广谱Β-内酰胺酶
表型
耐药
基因分型
Klebsiella pneumoniae
Extended spectrum β-1actamase
Phenotype
Antibiotics resistant
Genotype
