肠杆菌科细菌AmpC酶与基因的检测及耐药分析-中国现代应用药学.PDFVIP

肠杆菌科细菌AmpC 酶与基因的检测及耐药分析 陈枫，唐小平，王晓燕，林雁，陈庄，黄永茂*(泸州医学院附属医院，四川 泸州 646000) 摘要：目的 研究肠杆菌科细菌产AmpC 酶情况以及对抗生素的敏感性。方法 收集临床分离的第3 代头孢菌素耐药肠 杆菌科细菌62 株。K-B 法对13 种抗菌药物敏感性、头孢西丁(FOX)耐药性进行初步筛选；酶粗提物头孢西丁三维实验检 测AmpC 酶；PCR 对产酶菌株AmpC 结构基因进行分析。结果 62 株肠杆菌科细菌对亚胺培南、头孢吡肟及阿米卡星 基金项目：四川省重点学科重点建设项目(SZD0421) 作者简介：陈枫，女，副教授 Tel: (0830)3165788 E-mail: chenf6305@ *通信作者：黄永茂，男，硕士，主任医师 Tel: (0830)3165788 E-mail: huang5616@ 中国现代应用药学2012 年5 月第29 卷第5 期 Chin JMAP, 2012 May, Vol.29 No.5 ·433 · 耐药率低，对氨苄西林-舒巴坦、头孢曲松、头孢他啶等抗菌药物的耐药率较高，FOX 的初筛阳性菌有 22 株；其中 17 株检测到AmpC 基因，并且8 株细菌三维实验阳性。结论 产AmpC 酶菌株对各种抗生素的耐药率比非产酶菌株明显增 高。治疗产AmpC 酶细菌所引起的感染以亚胺培南或头孢吡肟为首选，左氧氟沙星、阿米卡星等可作为选用药物之一。 关键词：AmpC 酶；肠杆菌科细菌；三维实验 中图分类号：R978.1 文献标志码：B 文章编号：1007-7693(2012)05-0433-05 Detection and Analysis of Antibiotic Resistance of AmpC Enzyme and Its Gene in Enterobacteriaceae * CHEN Feng, TANG Xiaoping, WANG Xiaoyan, LIN Yan, CHEN Zhuang, HUANG Yongmao (Affiliated Hospital of Luzhou Medical College, Luzhou 646000, China) ABSTRACT: OBJECTIVE To study the production of AmpC enzymes and the sensitivity to antibiotics in the Enterobacteriaceae. METHODS Sixty two Enterobacteriaceae resistant to third generation cephalosporins were collected, the susceptibility to 13 kinds of antimicrobial drug and the drug tolerance to cefoxitin (FOX) were detected with K-B method. AmpC enzyme was detected by the enzyme extracts FOX three-dimensional test. And structural gene of AmpC was analyzed by PCR. RESULTS The resistant rate of 62 Enterobacteriaceae strains was low to cefepime, imipenem and amikacin, but high resistance to ampicillin/sulbactam, ceftriaxone, ceftazidime. There were 22 positive bacteria screened by FOX, 8 three-dimensional test positive bacteria; and 17 strains bacteria in which