摘要
目的探讨KPN多重耐药性及AMEs基因携带状况,为临床治疗及控制医院感染提供依据。方法采用K-B纸片法进行药敏试验,筛选多重耐药KPN,三维试验检测ESBLs和AmpC酶,再用PCR检测AMEs基因并序列分析。结果61株多重耐药KPN对IMP无耐药,氨基糖苷类抗菌药物耐药率为60.7-100.%,其他抗菌药物耐药率为44.3～100%;产ESBLs、AmpC酶、同时产ESBLs和AmpC酶检出率分别为31.1%、14.8%、45.9%,有8.2%均未检出;AMEs基因阳性检出率86.9%,其中aac(3)-Ⅰ、aac(3)-Ⅱ、aac(6')-Ⅰb、aac(6')-Ⅱ、ant(3")-Ⅰ和ant(2")-Ⅰ阳性检出率分别为13.1%、60.7%、55.7%、11.5%、6.6%和26.2%。结论KPN多重耐药严重,临床可选择的药物有限,产ESBLs、AmpC酶和携带AMEs基因较高,临床应根据药敏试验结果,合理选用抗菌药物,以便减少耐药菌株传播流行。
Objective To study the multiple-resistance of Klebsiella pneumoniae and its aminoglycosides-modifying enzymes gene for the evidence to clinic. Methods Using K-B paper disc test antibiotics sensitivity and screen Klebsiella pneumoniae strains with multiple-resistance. ESBLs and AmpC enzymes were detected with 3-D test. AMEs gene was analyzed by PCR. Results 61 strains of Klebsiella pneumoniae with multiple-resistance showed no resistance to IMP. The resistant rate to aminoglycosides antibiotics was from 60.7% to 100.%, and with 44.3% to 100% of other antibiotics. The detective rates of Klebsiella pneumoniae producing either ESBLs or AmpC enzyme and producing both were 31.1%,14.8% and 45.9% respectively. The positivity of AMEs gene was 86.9%, including aac（3）-I、aac（3）-Ⅱ、aac（6′）-I b、aac（6′）-Ⅱ、ant（3″）-I and ant（2″）-I, were 13.1%, 60.7%, 55.7%, 11.5%, 6.6% or 26.2% respectively. Conclusions The drug-resistance of Klebsiella pneumoniae with high production with ESBLs and AmpC enzymes and high carriage of AMEs gene is serious. Effective antibiotics based on antibiotic-sensitivity is helpful to reduce the spread of Klebsielta pneumoniae strains with antibiotics-resistance.
出处
《实验与检验医学》
CAS
2008年第5期481-483,共3页
Experimental and Laboratory Medicine
基金
江西省卫生厅科技计划项目(20063266)
关键词
多重耐药
肺炎克雷伯菌
基因
氨基糖苷类修饰酶
Multiple -resistance
Klebsiella
Pneumoniae
Gene
Aminoglycosides-modifying enzyme
