产ESBLs肺炎克雷伯菌耐药性及基因分型 FREE

Antimicrobial resistance and gene typing of extendedspectrum βlactamasesproducing Klebsiella pneumoniae FREE

摘要:

目的了解某院临床分离的产超广谱β内酰胺酶（ESBLs）肺炎克雷伯菌的耐药性及基因型。方法收集临床分离的肺炎克雷伯菌，采用美国临床实验室标准化委员会2005年推荐的方法进行ESBLs初筛及表型确证试验；KB纸片扩散法进行抗菌药物敏感性试验；聚合酶链反应（PCR）法分析产ESBLs菌株的基因类型。结果产ESBLs肺炎克雷伯菌的检出率为62.22%（56/90）。产ESBLs菌仅对第三代头孢菌素与β内酰胺酶抑制剂合剂、碳青霉烯类抗生素较敏感。基因型分析结果显示，产ESBLs肺炎克雷伯菌中SHV型、CTXM1型、TEM型、CTXM9型的检出率分别为69.64%、51.79%、37.50%、0.00%，同时携带2种、3种耐药基因的菌株分别占35.71%和14.28%。结论产ESBLs肺炎克雷伯菌耐药严重，基因型以SHV、CTXM1为主

Abstract:

Antimicrobial resistance and gene typing of extendedspectrum βlactamasesproducing Klebsiella pneumoniaeLIU Xiaochun,WANG Guoqing,WANG Rong, LIU Yunde (Department of Laboratory Medicine, Tianjin Medical University, Tianjin 300203, China)［Abstract］ObjectiveTo investigate antimicrobial resistance and genotypes of extendedspectrum βlactamases(ESBLs)producing Klebsiella pneumoniae(K. pneumoniae) isolated from clinic in a hospital . MethodsK. pneumoniae were collected, ESBLs preliminary screen and phenotype confirmatory tests were carried out according to the NCCLS guidelines; antimicrobial susceptibility tests were determined by KirbyBauer test; gene types of βlactamases were performed with PCR . ResultsThe detection rate of ESBLsproducing K. pneumoniae was 62.22%(56/90). ESBLsproducing strains were only sensitive to the combination of the third generation cephalosporins with βlactamases inhibitor and carbapenems. The detection rate of genes of SHV, CTXM1, TEM and CTXM9 was 69.64%, 51.79%, 37.50% and 0.00% respectively. 35.71% and 14.28% of ESBLproducing K. pneumoniae carried two or three genes respectively. ConclusionAntimicrobial resistance of K. pneumoniae is serious, the main gene types are SHV and CTXM1