侵肺巴斯德菌β-内酰胺类耐药机制的初步研究

Preliminary Study of β-lactam Resistance Mechanism of Pasteur Bacteria

目的 探讨侵肺巴斯德菌β-内酰胺类耐药机制.方法 用美国BD公司phoenixTM100全自动细菌鉴定/药敏仪对临床分离的一株侵肺巴斯德菌进行鉴定和抗生素敏感性检测,应用头孢硝噻吩（Ncf）试验检测其β-内酰胺酶（BLs）,多底物纸片法分类检测各种β-内酰胺酶.结果 phoenixTM100仪鉴定为侵肺巴斯德菌,可信度（ID）98%;对青霉素类、头孢菌素类、头霉素类、单环β-内酰胺类、氨基糖苷类耐药,对碳青霉烯类、四环素类、氯霉素、多黏菌素敏感;Ncf试验弱阳性,FEP协同试验阳性（同时产ESBLs和AmpC酶）.结论 该临床分离侵肺巴斯德菌株系二重耐药（β-内酰胺类和氨基糖苷类）;其β-内酰胺类耐药机制为产β-内酰胺酶,推测为同时产ESBLs和AmpC酶.经检索中文生物医学期刊文献数据库（CMCC）、GenBank和medline数据库,该研究是第一篇研究侵肺巴斯德菌β-内酰胺类耐药机制的报道.

Objective To investigate the resistant mechanisms of β-lactam of Pasteur bacteria in a clinical sample. Methods Identificated the strain and detected the antibiotic susceptibility with USA BD＇s phoenixTM100. Then determined β-lactamase of the strain with nitrocefin（Ncf） test and the variety of β-lactamases with a multi-disk test. Results The strain identificated by phoenixTM 100 was Pasteur bacteria, ID98%. The strain was resistant to penicillins,eephems, aminoglycosides and cephamycins ,monobactams ,susceptible to carbapenems ,tetracyclines ,chloramphenicol and polymyxin. The detection of Ncf was positive;FEP synergy test was positive （production of ESBLs and AmpC β-lactamase）. Conclusion The strain of Pasteur bacteria from a clinical sample was double drug-resistant （β-lactam and aminoglycosides）, the resistant mechanism of β-lactam was produetlng β-lactamase,speculated to product extended-spectrum β-lactamase and ArnpC β-lactamase.