医院感染阴沟肠杆菌多重耐药基因分析

Multiple drug-resistant genes of Enterobacter cloacae in hospital infection

目的了解医院感染阴沟肠杆菌的耐药性及其耐药基因,为防控感染提供依据。方法对40株临床分离的阴沟肠杆菌,以纸片扩散法和琼脂稀释法进行药敏试验,聚合酶链反应(PCR)及序列分析法分析12种耐药相关基因。结果 40株阴沟肠杆菌仅对亚胺培南和美罗培南高度敏感,敏感率均为100.00%;对头孢吡肟耐药率较低,为15.00%;对其他15种抗菌药物耐药率较高,为42.00%～92.50%。共检出8种耐药基因,分别为TEM-1、SHV-2a、CTX-M-3、CTX-M-9、AmpC、aac(3′)-Ⅰ、IntⅠ1、sul1,大多数菌株携带sul1+IntⅠ1型基因;耐药谱共分为A～I9型,以C和D型为主。抗菌药物耐药谱分型和基因分型有一定相关性。结论阴沟肠杆菌呈现多重和高度耐药性,耐药机制复杂且呈多种耐药机制共同作用。

Objective To investigate drug-resistance and multiple drug-resistant genes of Enterobacter cloacae （E. cloacae） in nosocomial infection（NI）, so as to provide evidence for the treatment of IN. Methods Forty trains of E. cloacae isolated from clinic were performed antimicrobial susceptibility test by disc agar diffusion and agar dilution method, twelve kinds of antimicrobial-resistant genes were detected by polymerase chain reaction（PCR） and DNA sequencing. Results Forty strains of E. cloacae were only highly sensitive to imipenem and meropenem, sensitive rate were all 100. 00 % ;the resistant rate to cefepime was low（15.00 %）; and resistant rates to the other 15 kinds of antimicrobial agents were high （42. 00-92. 50%）. Eight kinds of drugresistant genes were detected, which was TEM-1 ,SHV-2a,CTX-M-3, CTX-M-9, AmpC,aac（3＇）-I ,Int ] 1 and sull ,sull ＋ Int I 1 was the main pattern; drug-resistant pattern was divided into A-I 9, the main pattern were C and D. Conclusion E. cloacae shows a multiple and high drug-resistance, resistant mechanisms are complicated and varied.