摘要
目的探讨碳青霉烯类耐药阴沟肠杆菌耐药机制及同源性。方法选取2014年10月~2016年3月南昌仁爱妇产医院、南昌大学第二附属医院、抚州市第一人民医院检验科分离出的60株耐碳青霉烯类阴沟肠杆菌作为研究对象,采用药敏实验分析耐药率、改良Hodge试验及乙二胺四乙酸(EDTA)协同试验检测碳青霉烯酶、聚合酶链反应(PCR)扩增耐药基因并确定基因型、脉冲场凝胶电泳(PFGE)分析菌株同源性。结果 60株菌株对抗菌药物的耐药率前3位依次为:头孢西丁(100.0%)、头孢他啶(90.0%)、氨曲南(90.0%),多黏菌素B耐药率最低(5.0%);改良Hodge试验阳性率为76.7%,EDTA协同试验阳性率为81.7%;60株菌株中检出碳青霉烯酶基因39株,其中KPC-2 3株,IMP-4 24株,IMP-8 12株,携带其他β-内酰胺酶基因45株;60株菌株经PFGE分为A-O 20种不同的型别59株,仅有1株多次分型均未成功。结论阴沟肠杆菌耐药机制主要与KPC、IMP基因有关。
Objective To explore the resistance mechanism aod homology of Enterobacter cloacae resistant to carbapenem.Methods 60 separated strains of Enterobacter cloacae resistant to carbapenem from October 2014 to March 2016 of Clinical Laboratory from Nanchang Charity Hospital for Gynecology and Obstetrics,the Second Hospital Affiliated to Nanchang University and the First People＇s Hospital of Fuzhou City were selected as study objects.Drug sensitivity test was used to analyze the resistance rate,modlfied Hodge test and EDTA synergy test were used to detected carbapenem, PCR was used to amplify resistance genes and determinate genotypes,PFGE was used to analyze Strain homology.Results The resistance rate of 60 strains to antibiotics in the top 3 were Cefoxitin （100.0%）,Ceftazidime （90.0%）, Atreonam （90.0%） and Polymyxin B was the lowest （5.0%）.The positive rate of modified Hodge test and EDTA synergy test were respectively 76.7% and 81.7%,and 39 strains of carbapenem gene were detected in the 60 strains,and 3 strains with KPC-2,24 strains with IMP-4,12 strains with IMP-8,45 strains with other β-lactamase gene;60 strains were divided into A-O by PFGE, 20 different types of 59 strains and only 1 strain was not successful in type.Conclusion The resistance mechanism of Enterobacter cloacae are mainly with KPC and IMP gene.
作者
谢逢春
胡龙华
宁长秀
金迎庆
XIE Feng-chun HU Long-hua NING Chang-xiu JIN Ying-qing(Department of Clinical Laboratory,Nanchang Charity Hospital for Gynecology and Obstetrics,Nanchang 330025,China Department of Clinical Laboratory,the Second Hospital Affiliated to Nanchang University,Nanchang 330025,China Department of Clinical Laboratory,the First People＇s Hospital of Fuzhou City in Jiangxi Province,Fuzhou 344000,China)
出处
《中国当代医药》
2017年第6期126-128,共3页
China Modern Medicine
关键词
碳青霉烯酶
阴沟肠杆菌
耐药机制
同源性
Carbapenem
Enterobaeter cloacae
Resistance mechanism
Homology
