本文關(guān)鍵詞： 腸桿菌科細(xì)菌 碳青霉烯類 NDM- 耐藥性　出處：《中國病原生物學(xué)雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的檢測(cè)部分發(fā)酵類腸桿菌科細(xì)菌對(duì)臨床推薦用抗生素的敏感性并篩查耐碳青霉烯類基因。方法采集鄂西北地區(qū)2013年1-12月間住院病人的血、痰、中段尿、前列腺液、分泌物或引流液等,常規(guī)瓊脂培養(yǎng)法分離發(fā)酵類腸桿菌肺炎克雷伯菌(Klebsiella pneumoniae)、產(chǎn)酸克雷伯菌(Klebsiella oxytoca)、大腸埃希菌(Escherichia coli)、陰溝腸桿菌(Enterbacter cloacae)及沙雷氏菌(Serratia);利用Vitek-2分析系統(tǒng)鑒定菌株并檢測(cè)其耐藥性;PCR法擴(kuò)增抗碳青霉烯類(亞胺培南和/或美羅培南)菌株耐藥基因。結(jié)果共獲得2 291株肺炎克雷伯菌、大腸埃希菌、陰溝腸桿菌和沙雷氏菌等分離株,產(chǎn)ESBLs率分別為47.4%、62.6%、9.1%、22.6%;臨床推薦用抗生素耐藥率:頭孢唑啉(Ⅰ)分別為45.4%、73.7%、93.3%、100%,頭孢西丁(Ⅱ)分別為17.3%、15.2%、84.9%、33.3%,頭孢曲松(Ⅲ)分別為48.4%、65.0%、43.8%、44.4%;阿米卡星分別為17.4%、10.4%、28.1%、24.4%,氨曲南分別為35.4%、38.9%、49.1%、38.9%,亞胺培南(分別為1.8%、1.8%、17.6%、2.4%,美羅培南分別為1.1%、0.8%、6.7%、20%。其中分離出46株耐亞胺培南和/或美羅培南菌株,肺炎克雷伯菌P2964和肺炎克雷伯菌B195攜帶blaKPC-2基因,肺炎克雷伯菌P6558和產(chǎn)酸克雷伯菌B1645-1攜帶blaNDM-1基因。結(jié)論鄂西北地區(qū)部分發(fā)酵類腸桿菌耐藥率呈上升趨勢(shì)并出現(xiàn)耐碳青霉稀類菌株,菌株間可能存在耐藥基因的傳遞并有造成感染擴(kuò)散的風(fēng)險(xiǎn),尤其在住院病人之間,應(yīng)予以高度重視。
[Abstract]:Objective to detect the sensitivity of some enterobacteriaceae fermentative bacteria to clinical recommended antibiotics and to screen carbapenem resistant genes. Methods Blood and sputum were collected from hospitalized patients in Northwest Hubei from 2013 to December. Median urine, prostatic fluid, secretion or drainage fluid were isolated from Klebsiella pneumoniae by routine Agar culture. Klebsiella oxytocai, Escherichia coli. Enterbacter cloacaeae and Serratia Shareh; The strains were identified by Vitek-2 analysis system and their drug resistance was detected. The resistant genes of carbapenem resistant strains (imipenem and / or meropenem) were amplified by PCR. A total of 2 291 strains of Klebsiella pneumoniae and Escherichia coli were obtained. The ESBLs production rates of Enterobacter cloacae and Shareh's bacteria were 47.4 and 62.6, respectively. The rate of antibiotic resistance recommended for clinical use: cefazolin (鈪，

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