[1]徐小红,巫之韵,蔡美莉,等.产酸克雷伯菌耐碳青霉烯类抗生素耐药机制的研究[J].现代检验医学杂志,2017,32(01):19-21.[doi:10.3969/j.issn.1671-7414.2017.01.006]
　XU Xiao-hong,WU Zhi-yun,CAI Mei-li,et al.Study on the Resistance Mechanisms of Carbapenem-Resistant Klebsiella Oxytoca[J].Journal of Modern Laboratory Medicine,2017,32(01):19-21.[doi:10.3969/j.issn.1671-7414.2017.01.006]
点击复制

产酸克雷伯菌耐碳青霉烯类抗生素耐药机制的研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年01期
页码:
19-21
栏目:
论著
出版日期:
2017-01-25

文章信息/Info

Title:
Study on the Resistance Mechanisms of Carbapenem-Resistant Klebsiella Oxytoca
文章编号:
1671-7414(2017)01-019-03
作者:
徐小红1; 巫之韵1; 2; 蔡美莉1; 王梅华1; 陈莺1; 曹颖平1; 李 彬1
1.福建医科大学附属协和医院检验科,福州 350001;
2.福建医科大学,福州 350001
Author(s):
XU Xiao-hong1; WU Zhi-yun1; 2; CAI Mei-li1; WANG Mei-hua1; CHEN Ying1; CAO Ying-ping1; LI Bin1
1.Department of Clinical Laboratory,Union Hospital of Fujian Medical University, Fuzhou 350001,China;
2.Fujian Medical University,Fuzhou 350001,China
关键词:
产酸克雷伯菌; 碳青霉烯酶; 金属β-内酰胺酶; 肺炎克雷伯菌碳青霉烯酶; 耐药机制
分类号:
R378.996; R446.5
DOI:
10.3969/j.issn.1671-7414.2017.01.006
文献标志码:
A
摘要:
目的 分析产酸克雷伯菌耐碳青霉烯类抗生素的分子机制。方法 收集福建医科大学附属协和医院2011年8月～2012年8月临床分离非重复耐碳青霉烯类抗生素的产酸克雷伯菌菌株5株,检测厄他培南(ETP)、亚胺培南(IPM)及美罗培南(MEM)的最低抑菌浓度(MIC)筛查菌株; 采用改良Hodge试验进行碳青霉烯酶表型鉴定、琼脂稀释法测其药敏; 聚合酶链反应(PCR)扩增超广谱β-内酰胺酶(ESBLs)、碳青霉烯酶耐药基因; 对检出碳青霉烯类基因的产酸克雷伯菌进行接合试验。结果 5株产酸克雷伯菌对17种抗菌药物中耐药率≥80%的有9种,分别为头孢西丁、头孢他啶、头孢噻肟、头孢吡肟、厄他培南、亚胺培南、庆大霉素、头孢哌酮/舒巴坦、氨曲南。对替加环素、美罗培南、多黏菌素B和哌拉西林/他唑巴坦的耐药性较低。改良Hodge试验检出4例产碳青霉烯酶。 2株携带碳青霉烯类耐药基因(1株仅IMP-4阳性,1株KPC-2和IMP-8同时阳性),3株检出β-内酰胺酶基因。结论 福建医科大学附属协和医院产酸克雷伯菌耐碳青霉烯类抗生素耐药机制可能为携带IMP及KPC基因,并且发现了产酸克雷伯菌同时携带两种碳青霉烯类耐药基因的现象。
Abstract:
Objective To investigate the resistance mechanism of Carbapenem-Resistant Klebsiella oxytoca.Methods Carbapenem-Resistant Klebsiella oxytoca were collected from Fujian Medical University Union Hospital.The modified hodge test(MHT)was used for carbapenemase phenotype screening.The minimum inhibit concentration(MIC)was detectedusing agar dilution method for 17 drugs.PCR and DNA sequencing were used to detect common β-Lactamase genes and carbapenemases genes.Conjugation experiments demonstrated the transferability of the carbapenem-resistant determinants.Results 5 Carbapenem-Resistant Klebsiella oxytoca of 4isolates were positive detected by MHT.Minimum inhibit concentration was detected by using agar dilution method for 17 drugs.More than 80% isolates were resistance to nine drugs.2 isolates conjugated successfully of 5 Carbapenem-Resistant Klebsiella oxytoca Isolates.There were 2 isolates included carbapenemasesgene(1 isolates were only IMP producers,1 isolate contained the IMP and KPC),3 isolates produce ESBLs gene.Conclution The due to CREstrains isolated from Fujian Medical University Union Hospital may be metallo-enzyme carbapenemase and KPC gene.And the isolate that produce two Carbapenem-Resistant gene had been found in this hospital.

参考文献/References:

[1] 徐小红.碳青霉烯类耐药肠杆菌科细菌耐药机制及危险因素分析[D].福建:福建医科大学,2014. Xu XH.Study on the resistabce mechanisms and clinical risk factorsof Carbapenem-Resistant Enterobacteriaceae Isolates[D].Fujian:Fujian Medical University,2014.
[2] Yigit H,Queenan AM,Anderson GJ et al.Novel carbapenem-hydrolyzing beta-lactamase KPC-1 from a carbapenem-resistant strain of Klebsiella pneumonia[J].Antimicrob Agents Chemother,2001,45(4):1151-1161.
[3] 宁明哲,张之烽,周万青,等.耐亚胺培南的肺炎克雷伯菌碳青霉烯酶基因检测及其同源性分析[J].现代检验医学杂志,2014,29(2):58-59,63. Ning MZ,Zhang ZF,Zhou WQ,et al.Carbapenemase gene detection andhomology analysis of imrpenem-resistant Klebsiella pneumoniae[J].Mod LabMed,2014,29(2):58-59,63.
[4] Li B,Xu XH,Zhao ZC,et al.High prevalence of metallo-β-lactamase among carbapenem-resistant Klebsiella pneumoniae in a teaching hospital in China[J].Can J Microbiol,2014,60(10):691-695.
[5] Tsai YK,Liou CH,Fung CP,et al.Single or in combination antimicrobialresistance mechanisms of Klebsiella pneumoniae contribute to varied susceptibility to different carbapenems[J].PLoS One,2013,8(11):e79640.
[6] Balm MN,Ngan G,Jureen R,et al.OXA-181-producing Klebsiella pneumoniae establishing in Singapore[J].BMC Infectious Diseases,2013,13(1):58.
[7] Gomez S,Pasteran F,Faccone D,et al.Intrapatient emergence of OXA-247:a novel carbapenemase found in a patient previously infected with OXA-163-producing Klebsiella Pneumoniae[J].Clinical Microbiology and Infectiona,2013,19(5):233-235.
[8] Huang TD, Berhin C, Bogaerts P,et al.Prevalence and mechanisms of resistanceto carbapenems in Enterobacteriaceae isolates from 24 hospitals in Belgium[J].J Antimicrob Chemother,2013; 68(8):1832-1837.
[9] 甘龙杰,吴秀风,高丽钦,等.碳青霉烯类耐药肺炎克雷伯菌基因型检测及同源性分析[J].中国微生态学杂志,2014,26(3):316-318. Gan LJ,Wu XF,Gao LQ,et al.Analysis genotype and homology of carbapen ems-resistant Klebsiella pneumoniae[J].Chinese Journal of Microecology,2014,26(3):316-318.
[10] DeLeoa FR,Chen L,Porcella SF,et al.Molecular dissection of the evolution of carbapenem-resistant multilocus sequence type 258 Klebsiella pneumoniae[J].Proc Natl Acad Sci USA,2014,111(13):4988-4993.

相似文献/References:

[1]白　倩,赵　雅,王　林.临床克雷伯菌属碳青霉烯酶三种检测方法的实验比较研究[J].现代检验医学杂志,2022,37(01):149.[doi:10.3969/j.issn.1671-7414.2022.01.030]
　BAI Qian,ZHAO Ya,WANG Lin,et al.Comparative Study on Three Detection Methods of Clinical Carbapenemase Producing Klebsiella[J].Journal of Modern Laboratory Medicine,2022,37(01):149.[doi:10.3969/j.issn.1671-7414.2022.01.030]
[2]郑　茂a,陈宗耀a,鄂建飞a,等.高毒力肺炎克雷伯菌对碳青霉烯类耐药机制研究进展[J].现代检验医学杂志,2022,37(01):207.[doi:10.3969/j.issn.1671-7414.2022.01.043]
　ZHENG Maoa,CHEN Zong-yaoa,E Jian-feia,et al.Research Progress on the Mechanism of Hypervirulent Klebsiella Pneumoniae Resistance to Carbapenems[J].Journal of Modern Laboratory Medicine,2022,37(01):207.[doi:10.3969/j.issn.1671-7414.2022.01.043]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81201328,81171656); 福建省高校杰青项目(JA13134); 福建省卫计委中青年骨干人才培养项目(2015-ZQW-ZD-15)。
作者简介:徐小红(1987-),女,检验师,硕士研究生,研究方向:细菌耐药机制,E-mail:vancy1988@163.com。
通讯作者:曹颖平,E-mail:caoyingping@aliyun.com; 李彬,E-mail:leonlee307@126.com。
更新日期/Last Update: 2017-01-20