社区获得性肺炎中肺炎克雷伯菌耐药性及产AmpC酶基因菌株的检测

The Detection of Drug Resistance and Producing AmpC Enzyme Gene Condition of Klebsiella pneumoniae in Community-Acquired Pneumonia

目的:探讨社区获得性肺炎(CAP)患者肺炎克雷伯菌耐药性及产β-内酰胺(AmpC)酶情况。方法:CAP患者72例,吸取痰液进行肺炎克雷伯菌培养筛选分离,采用K-B法检测肺炎克雷伯菌对8种抗菌药物的耐药性,聚合酶链式反应(PCR)检测肺炎克雷伯菌中AmpC酶基因的表达。结果:72例患者共检出100株细菌,肺炎克雷伯菌30株(30%);肺炎克雷伯菌对亚胺培南无耐药性,对头孢吡肟、阿米卡星的耐药率较低,而对青霉素类和第2、3代头孢类药物耐药率较高;在30株肺炎克雷伯菌中,检出AmpC阳性表达菌株11株(36.7%)。结论:肺炎克雷伯菌对青霉素类和第2、3代头孢类药物耐药,产AmpC酶基因检出率较高。

Objective： To investigate the drug resistance and producing AmpC enzyme gene conditions of Klebsiella pneumoniae of community-acquired pneumonia. Methods： Sputum from 72 CAP patients was collected for Klebsiella pneumoniae, and they were given eight different kinds of drug-resist- ant testing, while the AmpC enzyme gene expression were detected with PCR. Results： One hundred bacteria strains were detected from 72 patients, among them 30 strains （30%） were Klebsiella pneu- mon/ae. The Klebsiella pneumordae strains showed no drug resistance to imipenem, and showed low resistance to cefepime and amikacin, and its resistance to penicillins, second and third generation cephalosporins were higher. In 30 Klebsiella pneumoniae strains, AmpC of 11 （36.7%） strains were positive. Conclusion： Klebsiella pneumonia shows higher drug resistance to penicillins, second and third generation cephalosporins, producing AmpC enzyme gene rate is high.