产吲哚金黄杆菌耐药性及其携带MBL-INDuniv研究

DETECTION OF METALLO-B-LACTAMASE PRODUCED BY CHRYSEOBACTERIUM INDOLOGENES AND THEIR MBL - INDuniv GENOTYPES

目的了解2007-2010年41株产吲哚金黄杆菌(chryseobacterium indologenes)临床分布、耐药特征、产金属酶及其携带MBL-INDuniv的情况。方法 K-B法检测41株产吲哚金黄杆菌对17种抗菌药物的敏感性。三纸片增效法进行金属β-内酰胺酶(metallo-beta-laetamase,MBL)简称金属酶表型检测,通过聚合酶链反应(polymerasechain reaction,PCR)筛查MBL-INDuniv基因的分布情况。结果 41株产吲哚金黄杆菌多来自呼吸科和ICU病房,最常见为呼吸道标本,占53.6%,对头孢他啶、氨曲南耐药率均为100%,亚胺培南、美罗培南的耐药率分别为为90.9%、87.8%,对常用抗阳性球菌药物如万古霉素、克林霉素耐药率在70%以下,米诺环素100%敏感。表型检测MBL菌株32株,MBL产酶率78.0%。PCR IND-univ通用引物扩增出18株阳性占43.9%。结论本地区的产吲哚金黄杆菌具有极强的耐药性和很高的MBL检出率,且MBL以IND基因型为主,应进一步密切关注该菌的传播及流行情况。

Objective To investigate the distribution, antibiotical resistance, metallo - enzyme production and MBL - INDuniv genotypes in 41 strains of Chryseobacterium indotogenes during the last three years. Methods The drug susceptibility to 17 antibiotics of the 41 C. indologenes strains was detected by K - B disc diffusion method. Phenotype of metallo - β - laetamase was detected by three - disc synergy test. polymerase chain reaction （PCR） amplification for MBL- INDuniv gene was conducted for all isolates. Results Forty - one strains Chryseobacterium indologenes were mainly from respiratory and ICU wards, most of which was respiratory tract specimens, accounting for 53.6%. The antibiotical resistance of Chryseobacterium indologenes to cefiazidime, aztreonam, imipenem and meropenem was 100% , 100% ,90.9% , 87.8% , respectively. However, the antibiotical resistance to anti -positive cocci antibiotic such as vancomycin, clindamycin resistance rates was less than 70%. And its antibiotical sensitivity to Minocycline was 100%. Thrity - two strains was positive for metallo - beta - lactamase phenotypic detection. Enzyme producing rate for MBL was 78.0%. Eighteen strains were detected to have metallo -β- lactamase genotype by PCR amplification using INDuniv common prime, accounting for 43. 9%. Conclusions Chryseobacterium indologenes has high rate of antibiotical resistance and metallo -β- laetamase producing in this region. The major genotype of metallo - β - lactamase is IND. Department the spread and prevalence of chryseobacterium indologenes should be paid more attention.