摘要
目的探讨阴沟肠杆菌分离菌株的临床分布及其对常用抗菌药物的耐药及产碳青霉烯酶情况。方法收集2014年6月至2016年2月武汉大学人民医院298例患者分类标本培养的菌株,应用BD Phoenix^(TM) 100细菌鉴定及药敏系统鉴定菌种和药物敏感性,并适当补充K-B法药敏试验;对碳青霉烯类抗菌药物敏感性下降的菌株进行Carba NP实验表型确证,并且进行PCR测序确定基因型;采用阴沟肠杆菌的MLST技术进行分子分型。结果共检出非重复分离的阴沟肠杆菌298株,其中标本主要为痰液(29.87%),其次为尿液(25.50%)。科室分布中,神经外科(17.79%)检出最多,其次为肝胆外科(12.75%)。阴沟肠杆菌对头孢唑林的耐药率最高(98.1%)、其次为氨苄西林(89.7%);对碳青霉烯类抗菌药物耐药的菌株中,9株菌通过Carba NP实验检测,其中8株为阳性,1株为阴性。PCR扩增出4株产NDM-1基因的菌株,其中1株联合产VIM-19基因的菌株,一株单产VIM-19型基因,均经过测序比对验证。将4株产NDM-1碳青霉烯酶的细菌进行MLST分型,得到3个不同的ST型,分别为ST508,ST509和ST145。结论阴沟肠杆菌的耐药较为严峻,感控部门应加强对本地区产碳青霉烯酶菌的监测,以减少耐药菌的产生和播散。
Objective To investigate the clinical distribution of isolated Escherichia coli and its resistance to common antimicrobial agents and the production of carbapenemases. Methods Various strains of 298 patients from Wuhan University People＇s Hospital from June 2014 to February 2016 were collected. The strains were identified by BD PhoenixTM 100 bacterial identification and drug susceptibility system. On The strains of alkene antimicrobial with sensitivity decreasing to carbon penicillium were confirmed by Carba NP, genotypes were determined by PCR. The MLST technique of Enterobacter cloacae was applied for molecular typing. Results Total of 298 strains of Enterobacter cloacae were detected, among which the samples were mainly from sputum （29.87%）, followed by urine （25.50%）. In the departments distribution, neurosurgery （17.79%） was the most, followed by hepatobiliary surgery （12.75%）. The resistance rate of Enterobacter cloacae to cefazolin was 98.1%, followed by ampicillin （89.7%）. Among the strains resistant to carbapenem antibiotics, 9 strains were detected by Carba NP test, 8 of which were positive, one strain was negative. Four strains ofNDM-1 gene were amplified by PCR. One strain carrying the VIM-19 gene and one carrying the VIM-19 gene alone were detected by sequencing. Four strains ofNDM-1 carbapenem were classified by MLST, and 3 different ST types were obtained, which were ST508, ST509 and ST145, respectively. Conclusions Antibiotic resistance of Enterobacter cloacae was grim, infection control departments should strengthen the monitoring of carbapenem to reduce the emergence and spread of drug-resistant bacteria.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2017年第3期239-244,共6页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
国家临床重点专科项目(No.2010305)
关键词
阴沟肠杆菌
抗菌药物
碳青霉烯酶
Enterobactercloacae
Antibacterials
Carbapenemases
