林平, 陈佳玉. 阴沟肠杆菌ESBLs、AmpC酶和AmpC酶基因型的 检测及耐药性分析[J]. 疾病监测, 2010, 25(6): 443-446. DOI: 10.3784/j.issn.1003-9961.2010.06.007
引用本文: 林平, 陈佳玉. 阴沟肠杆菌ESBLs、AmpC酶和AmpC酶基因型的 检测及耐药性分析[J]. 疾病监测, 2010, 25(6): 443-446. DOI: 10.3784/j.issn.1003-9961.2010.06.007
LIN Ping, CHEN Jia-yu. Detection of ESBLs,AmpC β-Lactamase and AmpC genotype in Enterobacter cloacae and analysis of their drug resistance[J]. Disease Surveillance, 2010, 25(6): 443-446. DOI: 10.3784/j.issn.1003-9961.2010.06.007
Citation: LIN Ping, CHEN Jia-yu. Detection of ESBLs,AmpC β-Lactamase and AmpC genotype in Enterobacter cloacae and analysis of their drug resistance[J]. Disease Surveillance, 2010, 25(6): 443-446. DOI: 10.3784/j.issn.1003-9961.2010.06.007

阴沟肠杆菌ESBLs、AmpC酶和AmpC酶基因型的 检测及耐药性分析

Detection of ESBLs,AmpC β-Lactamase and AmpC genotype in Enterobacter cloacae and analysis of their drug resistance

  • 摘要: 目的 探讨阴沟肠杆菌ESBLs和AmpC酶的产生情况、AmpC酶的耐药基因型及对常用抗菌药物的耐药特征,为临床治疗提供选药参考。 方法 采用VITEK-60型全自动细菌鉴定仪鉴定细菌,按美国临床实验室标准化委员会(CLSI)推荐的确证试验检测超广谱-内酰胺酶(ESBLs)和K-B纸片法测定药敏结果;采用头孢西丁纸片扩散法筛选疑产AmpC酶阳性菌株,并通过酶粗提物头孢西丁三维试验、接合试验、PCR测序等实验分析该菌株的基因型。 结果 157株阴沟肠杆菌ESBLs和AmpC酶总检出率分别为31.21%和32.48%,其中,单产AmpC酶、同产AmpC酶+ESBLs、单产ESBLs检出率分别为17.20%、7.64%和23.57%;AmpC酶阳性菌株的耐药基因型:30株为DHA型,9株为CIT型。产酶株的耐药性明显高于非产酶株,耐药现象在同产AmpC酶和ESBLs菌株中更为严重,产与非产AmpC酶(和)ESBLs菌株对亚胺培南的敏感率几乎达100%。 结论 台州地区阴沟肠杆菌产ESBLs和AmpC酶菌株检出率较高,AmpC酶以DHA-1基因型为主。产AmpC酶和ESBLs的菌株呈高度耐药,限制-内酰胺类抗菌药物的应用是减少产酶株流行的重要措施。

     

    Abstract: Objective To investigate the production of ESBLs and AmpC -Lactamase in Enterobacter cloacae, and identify AmpC -lactamase-producing strains and their resistance to common antibiotics, providing the basis for drug options in clinical treatment. Methods Microbiological identification was performed with the VITEK 60 System. The confirmatory test recommended by CLSI was carried out to detect ESBLs, and the Kirby-Bauer method was used to determine drug sensitivity. AmpC -lactamase-producing suspects were screened by cefoxitin disk diffusion, and their genotypes were analyzed using the cefoxitin three-dimensional test, conjugation test and PCR sequencing. Results Of 157 isolates, 31.32% were ESBLs-producing and 32.48% were AmpC -lactamase-producing strains. The proportion of simple AmpC -lactamase-producing, AmpC -lactamase-producing plus ESBLs-producing, and simple ESBLs-producing strains amounted to 17.20%, 7.64% and 23.57%, respectively. As for the drug-resistant genotypes of AmpC -lactamase-producing strains, 30 were of DHA type and 9 of CIT type. The resistance of -lactamase-producing isolates was obviously higher than non--lactamase-producing ones; and this difference was more noticeable when comparing to AmpC -lactamase- and ESBLs-producing ones. However, the sensitivity to imipenem was almost 100% in both groups regardless of the capability of producing -lactamase and/or ESBLs. Conclusion ESBLs- and AmpC--lactamase-producing Enterobacter cloacae are prevalent in Taizhou. DHA-1 genotype strains are the predominant AmpC--lactamase-producing bacteria. It is important to restrict the application of -lactam antibiotics to control the occurrence of these highly drug-resistant AmpC and ESBLs-producing germs.

     

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