發(fā)布時間：2018-05-09 21:51

  本文選題：碳青霉烯類抗菌藥物 + 腸桿菌科細(xì)菌��； 參考：《中華醫(yī)院感染學(xué)雜志》2016年21期

【摘要】：目的研究耐碳青霉烯類腸桿菌科細(xì)菌(CRE)的耐藥機制,為臨床合理使用抗菌藥物提供依據(jù)。方法連續(xù)收集某院2011年1月-12月臨床分離菌中非重復(fù)的腸桿菌科細(xì)菌2 203株,VITEK-2全自動微生物分析系統(tǒng)對其進(jìn)行鑒定及藥敏試驗;改良Hodge試驗初篩碳青霉烯酶;EDTA-亞胺培南(IPM)協(xié)同法和亞胺培南雙紙片增效法確認(rèn)金屬酶表型;PCR法檢測β-內(nèi)酰胺酶基因及整合子基因,產(chǎn)物測序,BLAST軟件比對分析。結(jié)果 2 203株腸桿菌科細(xì)菌中共檢出17株CRE,檢出率為0.7%;藥敏結(jié)果顯示,17株CRE菌株對常用抗菌藥物高度耐藥,除對阿米卡星和頭孢哌酮/舒巴坦的耐藥率低,分別為35.3%和47.1%,對其他抗菌藥物的耐藥率在76.4%~100.0%;17株菌均檢出blaTEM基因,6株肺炎克雷伯菌同時檢出blaSHV基因,并且其中1株肺炎克雷伯菌同時攜帶blaKPC-2基因,其余基因均陰性;3種整合子中intⅠ基因為陽性,檢出率高達(dá)70.6%。結(jié)論攜帶blaTEM、blaSHV和blaKPC-2基因是導(dǎo)致該院腸桿菌科細(xì)菌對碳青霉烯類抗菌藥物耐藥的重要原因,Ⅰ類整合子在其耐藥基因的轉(zhuǎn)移方面起了十分重要的作用。
[Abstract]:Objective to study the drug resistance mechanism of Enterobacteriaceae, and to provide evidence for rational use of antimicrobial agents in clinic. Methods A total of 2203 strains of Enterobacteriaceae isolates from January to December 2011 were collected and identified by VITEK-2 automatic microbiological analysis system. The improved Hodge method was used to identify the 尾 -lactamase gene and integron gene by the co-assay of EDTA-imipenem and imipenem double-disk synergy method. The products were sequenced by blast software. Results among the 2 203 strains of Enterobacteriaceae, 17 strains were found to have high resistance to common antimicrobial agents, except for amikacin and cefoperazone / sulbactam, and 17 strains were highly resistant to common antimicrobial agents, and the detection rate was 0.70.The results showed that 17 strains of CRE were highly resistant to common antimicrobial agents, except for amikacin and cefoperazone / sulbactam. The resistance rate to other antimicrobial agents was 76.4% and 47.1% respectively. BlaTEM gene was detected in 6 strains of Klebsiella pneumoniae and blaKPC-2 gene was detected in 1 strain of Klebsiella pneumoniae at the same time. All the other genes were negative and the positive rate of int 鈪，

本文編號：1867550