摘要
目的研究分离自儿童肺炎患者中肺炎克雷伯茵与大肠埃希茵产ESBLs及AmpC酶的耐药表型、基因型及分子流行病学特征。方法用表型筛出产ESBLs及AmpC酶的耐药株；再用基因芯片技术检测ESBLs与AmpC酶的基因型，并用ERIC-1RPCR进行分子流行病学分型；耐药质粒进行接合与转化；最后用wHONET5．4对试验数据进行分析。结果16株肺炎克雷伯茵SBLs基因型除-株外其余均同时检出TEM与SHV型，部分产CTx—M-9或CTX—M-3型；28株大肠埃希茵ESBLs基因型有25株均产CTX—M-9型，半数产TEM型，少数产SHV或CTX—M-3型；肺炎克雷伯茵AmpC酶基因型仅见DHA型，大肠埃希茼仅检出-株CIT型AmpC酶；ERIC-1RPCR分型可见各型散在分布；质粒接合ESBLs成功17株，AmpC成功4株，ESBLs＋AmpC成功2株，带有头孢西丁与四环素同时耐药的质粒4株转化成功。结论ES—BLs基因型多样而AmpC酶基因型单一；两种酶的耐药基因均可通过质粒传播。加强耐药茵的流行监测，预防控制耐药传播与扩散具有非常重要的作用。
Objective To study antibiotic resistence phenotype and genotypes as well as molecular epidemioligy of ESBLs and AmpC in Klebsiella pneumoniae（KPN）and Escherichia coli（ECO）from children of pneumoniae. Methods Resistent strains of ESBLs and AmpC were tested by phenotype. Gene chip technology were used to determine the genotypes of ES- BLs and AmpC. Taxon of molecular epidemioligy was tested in ERIC-1R method. Resistent plasmids were conjugated and transferred. Whonet 5.4 software was used for analysis of the antimicrobial susceptibility test. Results There were simul- taneously TEM and SHV of ESBLs in16strains KPN except one straint,a part of genotypes were CTX-M-3or CTX-M-9. There were 25 strains CTX-M-9type,a half part of TEM type,a few of SHV or CTX-M-3 type in 28 strains ECO. All genotypes of AmpC were DHA in KPN and only CIT type of AmpC in one strain ECO. Taxon of molecular Epidemioligy by ERIC-1R PCR were decentralized distribution. 17strains ESBLs, 4 strains AmpC and 2 strains ESBLs ＋ AmpC were conjugated successfully. 4 strains plasmid of resistant Cefoxitin and Tetracycline were transferred. Conclusions Genotypes of ESBLs were variety and AmpC weresingle. Resistent gene of twoβ-lactamases can be spreaded by plasmid. There is a very important role in strengthening epidemic supervised and preventing,contralling spread of resistant strains.
出处
《现代检验医学杂志》
CAS
2009年第4期49-53,共5页
Journal of Modern Laboratory Medicine
基金
基金项目：乌鲁木齐市科技局科研项目（Y053201）.
