碳青霉烯类药物非敏感肠杆菌科细菌基因型研究
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南京军区医学科技创新重点课题(10Z037)。


Genotype analysis of carbapenem-non-susceptible Enterobacteriaceae
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    摘要:

    摘要:目的:探讨临床分离的碳青霉烯类药物非敏感肠杆菌科细菌的基因型。 方法:收集2010年1月至2013年6月临床标本中分离的碳青霉烯类药物非敏感肠杆菌科细菌110株,K-B纸片扩散法检测细菌对临床常用药物的敏感性,纸片扩散表型确证试验检测超广谱β-内酰胺酶(ESBLs),改良Hodge试验(MHT)检测碳青霉烯酶表型,PCR、DNA测序及BLAST比对等方法确定菌株耐药基因型。 结果:110株碳青霉烯类非敏感肠杆菌科细菌中,MHT阳性77株(70.0%)。31株大肠埃希菌、1株产气肠杆菌和1株黏质沙雷菌检出blaKPC-2基因,5株阴沟肠杆菌和1株产气肠杆菌分别检出blaIMP-26和blaVIM-2基因。36株32.7%菌株ESBLs表型试验阳性,主要检出blaCTX-M-15、blaSHV-12和blaCTX-M-3 3种ESBLs基因型。 结论:本项研究碳青霉烯类非敏感肠杆菌科细菌以blaKPC-2基因型为主,其次为blaIMP-26和blaVIM-2基因型。

    Abstract:

    Abstract: Objective:To investigate the genotype of carbapenem-non-susceptible Enterobacteriaceae isolated from clinical specimens in our hospital. Methods:A total of 110 clinical isolates of carbapenem-non-susceptible Enterobacteriaceae were isolated from clinical specimens in our hospital during January 2010 to June 2013. The susceptibility of isolates to carbapenems was determined by the disk diffusion method. The extended spectrum β-lactamases (ESBLs) and the carbapenemase phenotypes of isolates were detected by the phenotypic confirmatory test and the modified Hodge test (MHT), respectively. Further, the genotypes of β-lactamases were determined by polymerase chain reaction (PCR), DNA sequencing and BLAST aligning. Results:Of 110 isolates of carbapenem-non-susceptible Enterobacteriaceae, 77 (70.0%) were positive for carbapenemase. PCR and DNA sequencing analysis showed that 31 isolates of E. coli, 1 E. aerogenes and 1 S. marcescens carried with blaKPC-2 gene, 5 isolates of E. cloacae with blaIMP-26 and 1 E. aerogenes with blaVIM-2. In addition, 36 (32.7%) of isolates produced ESBLs, and 3 genotypes, such as blaCTX-15, blaSHV-12 and blaCTX-3, were detected. Conclusion: blaKPC-2 was the major genotype of carbapenemase for the clinical isolates of carbapenem-non-susceptible Enterobacteriaceae in our hospital, followed by blaIMP-26 and blaVIM-2.

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胡雪,林迪,陈坚,杨丽君,杨燕,成军,陈东科,曾贤铭,孙长贵.碳青霉烯类药物非敏感肠杆菌科细菌基因型研究[J].临床检验杂志,2013,31(10):736-739

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  • 收稿日期:2013-08-15
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  • 在线发布日期: 2013-12-11
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