肠杆菌科细菌AmpC酶与基因的检测及耐药分析

Affiliated Hospital of Luzhou Medical College, Luzhou 646000, China

关键词:  AmpC酶  肠杆菌科细菌  三维实验

Key words:  AmpC enzyme  enterobacteriaceae  three-dimensional test

摘要:

目的 研究肠杆菌科细菌产AmpC酶情况以及对抗生素的敏感性。方法 收集临床分离的第3代头孢菌素耐药肠杆菌科细菌62株。K-B法对13种抗菌药物敏感性、头孢西丁(FOX)耐药性进行初步筛选；酶粗提物头孢西丁三维实验检测AmpC酶；PCR对产酶菌株AmpC结构基因进行分析。结果 62株肠杆菌科细菌对亚胺培南、头孢吡肟及阿米卡星耐药率低，对氨苄西林-舒巴坦、头孢曲松、头孢他啶等抗菌药物的耐药率较高，FOX的初筛阳性菌有22株；其中17株检测到AmpC基因，并且8株细菌三维实验阳性。结论 产AmpC酶菌株对各种抗生素的耐药率比非产酶菌株明显增高。治疗产AmpC酶细菌所引起的感染以亚胺培南或头孢吡肟为首选，左氧氟沙星、阿米卡星等可作为选用药物之一。

Abstract:

OBJECTIVE To study the production of AmpC enzymes and the sensitivity to antibiotics in the Enterobacteriaceae. METHODS Sixty two Enterobacteriaceae resistant to third generation cephalosporins were collected, the susceptibility to 13 kinds of antimicrobial drug and the drug tolerance to cefoxitin (FOX) were detected with K-B method. AmpC enzyme was detected by the enzyme extracts FOX three-dimensional test. And structural gene of AmpC was analyzed by PCR. RESULTS The resistant rate of 62 Enterobacteriaceae strains was low to cefepime, imipenem and amikacin, but high resistance to ampicillin/sulbactam, ceftriaxone, ceftazidime. There were 22 positive bacteria screened by FOX, 8 three-dimensional test positive bacteria; and 17 strains bacteria in which the AmpC gene were detected in the 22 screening-positive strains. CONCLUSION The resistant rate of the Enterobacteriaceae producing AmpC β-lactamases is significantly higher than those of non-producing AmpC. Imipenem or cefepime is the first-use drug for infections caused by AmpC-producing bacteria, and levofloxacin, amikacin are also effective for the treatment of such infections.