摘要
目的初步探讨败血症患儿血标本分离的人苍白杆菌耐药机制。方法采用VITEK2compact全自动微生物鉴定药敏系统对败血症患儿分离的病原菌进行鉴定和药敏试验;聚合酶链反应(PCR)法对人苍白杆菌受试株进行AmpC、AmpR、DHA-1、AcrA、RamA、OprD、TEM、SHV等多重耐药基因检测,扩增产物经纯化后测序并进行序列分析。结果从败血症患儿的血标本中检出155株人苍白杆菌,从中随机选取30株进行检测。30株试验菌株中,有20株耐哌拉西林/他唑巴坦,其中16株(80.00%,16/20)扩增出人苍白杆菌AmpC/R基因,2株(10.00%,2/20)扩增出DHA-1基因。30株受试菌均未扩增出AcrA、RamA、OprD、TEM、SHV等基因。将155株人苍白杆菌根据其是否耐哌拉西林/他唑巴坦,分成耐药组(126株)和非耐药组(29株),其中耐药组菌株对氨苄西林、第一～三代头孢菌素、氨曲南等几乎100%耐药,但对左氧氟沙星、亚胺培南、美罗培南、环丙沙星、阿米卡星、庆大霉素等耐药率(0.00%～1.59%)低。结论产AmpC/R是儿童感染人苍白杆菌耐多种抗菌药物的机制,重症患儿可选用亚胺培南。应加强对人苍白杆菌耐药性的监测,防止DHA基因在革兰阴性杆菌中流行。
ObjectiveTo evaluate drug resistance mechanisms of Ochrobactrum anthropi （O. anthropi） isolated from blood of children with septicemia. MethodsVITEK2 compact automatic machine was used to identify and analyze antimicrobial resistance of O. anthropi, and drugresistance gene AmpC, AmpR, DHA1, AcrA,RamA,OprD,TEM and SHV were determined by polymerase chain reaction （PCR） method, then PCR products were purified and sequenced. ResultsA total of 155 O. anthropi isolates were isolated, 30 of which were randomly selected for detection. Of 30 tested isolates, 20 were resistant to piperacillin / tazobactam, 16（80.00%，16/20） of which were detected AmpC/R genes, 2 （10.00%，2/20）were detected DHA1 gene. None of 30 isolates were amplified AcrA,RamA,OprD,TEM and SHV gene. According to the resistance to piperacillin/tazobactam, 155 isolates were divided into drugresistance group （126 isolates） and nondrugresistance group （29 isolates）, drugresistance group were all resistant to ampicillin, firstthird generation cephalosporins, aztreonam, but resistant rates to levofloxacin, imipenem, meropenem, ciprofloxacin, amikacin and gentamycin were low （0.00%-1.59%）.ConclusionProduction of AmpC/R is the mechanism of multidrug resistance of O. anthropi,critically ill patients can choose imipenem. The detection of drug resistance of O. anthropi should be reinforced to prevent the prevalence of DHA gene among gramnegative bacteria.
出处
《中国感染控制杂志》
CAS
2013年第3期169-172,共4页
Chinese Journal of Infection Control
基金
湖南省科技厅课题(2008FJ3193)
关键词
儿童
人苍白杆菌
败血症
血流感染
AMPC酶
DHA基因
抗药性
微生物
child
Ochrobactrum anthropi
septicemia
blood stream infection
AmpC enzyme
DHA gene
drug resistance, microbial
