中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2010年
3期
138-141
,共4页
郭远瑜%魏泽庆%朱佩琼%杜小幸%杨青%沈萍%俞云松
郭遠瑜%魏澤慶%硃珮瓊%杜小倖%楊青%瀋萍%俞雲鬆
곽원유%위택경%주패경%두소행%양청%침평%유운송
β-内酰胺酶类%基因型%克雷伯菌,肺炎%聚合酶链反应
β-內酰胺酶類%基因型%剋雷伯菌,肺炎%聚閤酶鏈反應
β-내선알매류%기인형%극뢰백균,폐염%취합매련반응
Beta-laetamases%Genotype%Klebsiella pneumoniae%Polymerase chain reaction
目的 研究医院感染肺炎克雷伯菌的β-内酰胺酶基因型.方法 连续收集从临床住院患者中分离的肺炎克雷伯菌,采用接合试验、PCR、PCR产物测序、等电聚焦试验、超广谱β-内酰胺酶(ESBLs)确认试验等方法明确基因型.结果 共收集75株肺炎克雷伯菌,48株(64.0%,48/75)含β-内酰胺酶基因,其中ESBLs占52.0%(39/75).在48株产酶菌株中,携带2种基因型的占35.4%(17/48),携带3种基因型的占14.6%(7/48),携带4种基因型的占10.4%(5/48).CTX-M型β-内酰胺酶基因的检出率最高(30/48,62.5%),其次为TEM型(26/48,54.2%)和SHV型(25/48,52.1%).产DHA-1型AmpC酶的肺炎克雷伯菌有9株,且有8株与ESBLs并存.同时还检测到3株产KPC-2型碳青霉烯酶肺炎克雷伯菌.ESBLs表型确认试验结果的假阴性率为23.1%(9/39).结论 医院感染肺炎克雷伯菌的β-内酰胺基因分布复杂,临床上呈多药耐药状态.
目的 研究醫院感染肺炎剋雷伯菌的β-內酰胺酶基因型.方法 連續收集從臨床住院患者中分離的肺炎剋雷伯菌,採用接閤試驗、PCR、PCR產物測序、等電聚焦試驗、超廣譜β-內酰胺酶(ESBLs)確認試驗等方法明確基因型.結果 共收集75株肺炎剋雷伯菌,48株(64.0%,48/75)含β-內酰胺酶基因,其中ESBLs佔52.0%(39/75).在48株產酶菌株中,攜帶2種基因型的佔35.4%(17/48),攜帶3種基因型的佔14.6%(7/48),攜帶4種基因型的佔10.4%(5/48).CTX-M型β-內酰胺酶基因的檢齣率最高(30/48,62.5%),其次為TEM型(26/48,54.2%)和SHV型(25/48,52.1%).產DHA-1型AmpC酶的肺炎剋雷伯菌有9株,且有8株與ESBLs併存.同時還檢測到3株產KPC-2型碳青黴烯酶肺炎剋雷伯菌.ESBLs錶型確認試驗結果的假陰性率為23.1%(9/39).結論 醫院感染肺炎剋雷伯菌的β-內酰胺基因分佈複雜,臨床上呈多藥耐藥狀態.
목적 연구의원감염폐염극뢰백균적β-내선알매기인형.방법 련속수집종림상주원환자중분리적폐염극뢰백균,채용접합시험、PCR、PCR산물측서、등전취초시험、초엄보β-내선알매(ESBLs)학인시험등방법명학기인형.결과 공수집75주폐염극뢰백균,48주(64.0%,48/75)함β-내선알매기인,기중ESBLs점52.0%(39/75).재48주산매균주중,휴대2충기인형적점35.4%(17/48),휴대3충기인형적점14.6%(7/48),휴대4충기인형적점10.4%(5/48).CTX-M형β-내선알매기인적검출솔최고(30/48,62.5%),기차위TEM형(26/48,54.2%)화SHV형(25/48,52.1%).산DHA-1형AmpC매적폐염극뢰백균유9주,차유8주여ESBLs병존.동시환검측도3주산KPC-2형탄청매희매폐염극뢰백균.ESBLs표형학인시험결과적가음성솔위23.1%(9/39).결론 의원감염폐염극뢰백균적β-내선알기인분포복잡,림상상정다약내약상태.
Objective To investigate the genotypes of β-lactamases produced by Klebsiella pneumoniae.Methods Plasmid conjugation,PCR amplification,gene cloning and DNA sequencing,isoelectric focusing electrophoresis and extended-spectrum β-lactamase(ESBLs)confirmatory test were carried out for analyzing the encoding gene of β-lactamases in clinical strains of Klebsiella pneumoniae collected from hospital wards.Results Totally 75 clinical strains of Klebsiella pneumoniae were collected,in which 48 strains were confirmed to produce genotype of β-laetamases(64.0%),including 39 ESBLs-producing Btraim(52.0%).Among 48 strains,17 isolates(35.4%)carried 2 types of ESBLs genes,7(14.6%)carried 3 types of ESBL8 genes,and 5(10.4%)carried 4 types of ESBLs genes.CTX-M was the most comon type(30/48,62.5%),followed by TEM(26/48,54.2%)and SHV(25/48,52.1%).Among 9 isolates with DHA-1 AmpC β-laetamase,8 produced AmpC β-lactamases and ESBLs.Class A carbapenemase KPC-2 was produced in 3 isolates.False negative rate of ESBLs confirmatory test was 23.1%(9/39).Condusion Genotypes of β-lactamases produced by Klebsiella pneumoniae are complicated,which results in multi-drug resistance in clinic.
