碳青霉烯类抗菌药物敏感性下降肠杆菌科细菌耐药基因型研究

Analysis of Carbapenemase Genotypes in Enterobacteriaceae Species with Reduced Susceptibility to Carbapenems

关键词:  肠杆菌科细菌  碳青霉烯酶  耐药基因

Key words:  Enterobacteriaceae species  carbapenemases  resistance gene

摘要:

目的 研究碳青霉烯类抗菌药物敏感性下降肠杆菌科细菌的耐药情况及产碳青霉烯酶基因型。方法 对临床分离到非重复的36株耐碳青霉烯类肠杆菌科细菌，应用改良Hodge试验进行产碳青霉烯酶的表型确证，PCR扩增技术分析产碳青霉烯酶基因型。结果 药敏试验显示36株碳青霉烯类耐药肠杆菌科细菌具有对第3，4代头孢菌素、碳青霉烯类、氟喹诺酮类和酶抑制剂复合制剂等多重耐药。36株菌株中有16株改良Hodge试验阳性；PCR结果10株细菌携带bla_KPC，未检出bla_IMP、bla_VIM、bla_GIM、bla_SIM、bla_NDM-1基因条带。结论 产KPC酶是台州医院碳青霉烯类抗菌药物敏感性下降肠杆菌科细菌的主要耐药机制，其中KPC是主要基因型。

Abstract:

OBJECTIVE To investigate the drug resistance and carbapenemase genetypes of the Enterobacteriaceae with reduced susceptibility to carbapenems. METHODS Carbapenemases-producing phenotype of 36 strains was analyzed by modified Hodge test, PCR amplification was used to analyze carbapenemase genotypes. RESULTS The susceptibility test showed that the 36 clinical isolates were multi-resistant strains, resistant to third-generation and forth-generation of cephalosporin, carbapenems, fluoroquinolones and β-lactamases inhibitor compounds. Modified Hodge test showed that 16 of all strains produced carbapenemase. PCR amplification indicated that 10 strains carried the carbapenemase genetype of bla_KPC. Genes of bla_IMP, bla_VIM, bla_GIM, bla_SIM, bla_NDM-1 were not detected in all strains. CONCLUSION The mainly carbapenem-resistant mechanism of Enterobacteriaceae is producing KPC enzyme in Taizhou Hospital. KPC genes are the most popular carbapenemnases coding genes.