抗菌药物对阴沟肠杆菌诱导型AmpCβ-内酰胺酶向持续高产型转变的影响作用

Influence of antibiotics on transition from inducible expression of AmpC β-Lactamase in Enterobacter cloacaeto continuous high expression

目的了解抗菌药物对阴沟肠杆菌由诱导型AmpC β-内酰胺酶向持续高产型转变的影响作用。方法 观察临床应用抗菌药物前后阴沟肠杆菌由诱导型AmpC β-内酰胺酶向持续高产型转变的转变率。结果 60株诱导型产酶的阴沟肠杆菌,有8株转变为持续高产型,转变率为13.3%;应用头孢菌素类、喹诺酮类、碳青霉烯类和头孢菌素类+β-内酰胺酶抑制剂的患者,阳性转变率分别为16.7%、11.1%、10.5%和20.0%。结论阴沟肠杆菌易受抗菌药物的影响发生突变,转变为持续高产型。

OBJECTIVE To investigate the influence of antibiotics on the transition from inducible expression of AmpC β-Lactamase in Enterobacter cloacae to continuous high expression.METHODS The rate of the transition from inducible expression type to continuous high expression type of AmpC β-Lactamase in E.cloacae was observed after the clinical application of antibiotics.RESULTS Among 60 strains of E.cloacae with inducible expression of AmpC,8 strains changed to continuous high expression with the transition rate of 13.3%.The positive transition rates in these patients treated with Cephalosporins,Quinolones,Carbapenems and cephalosporins＋ β-lactamase inhibitor were 16.7%,11.1%,10.5% and 20.0%,respectively.CONCLUSION E.cloacae isolates are susceptible to antibiotics and mutate to continuous high expression type.