肺炎克雷伯菌AmpC酶基因分型和随机扩增DNA多态性研究

Study on the Genotype of the AmpC Enzyme-producing Klebsiella Pneumoniae by Random Amplied Polymorphic DNA Method

目的了解我院肺炎克雷伯菌AmpC酶的基因分型及耐药情况,指导临床合理使用抗生素。方法采用K-B法初筛出可疑产AmpC酶的菌株,再用三维试验检测产AmpC酶的情况,用多重PCR进行基因分型、随机扩增DNA多态性技术进行同源性的分析。结果从临床260株肺炎克雷伯菌中初筛出57株可疑产AmpC酶的菌株,三维试验检测57株菌中AmpC酶阳性有51株,产AmpC酶的肺炎克雷伯菌大多数是DHA型占90%,只有很少一部分产MIX型占6%、FOX型占2%和ACC型占2%。通过15种药物对产AmpC酶肺炎克雷伯菌耐药性的分析,51株对亚胺培南的敏感性为98.0%,对头孢西丁耐药性为100%,对其他第三代头孢菌素的耐药性均超过70%。结论我院临床分离产AmpC酶的肺炎克雷伯菌主要基因型是DHA型,且呈多重耐药。

Objective This study aimed to investigate the genotype and antimicrobial resistance of Ampc enzymeproducing Klebsiella pneumoniae for the clinical reasonable using antibiotic in our hospital.Methods Preliminary screening of doubt Ampc enzyme-producing Klebsiella pneumoniae was made by Kirby-Bauer method,and the condition of creating Ampc enzyme was detected by three dimensional experiment.Then multiplicitas polymerase chain reaction and random amplied polymorphic DNA analyse were applied to genotyping and homology detecting respectively.Results Through preliminary screening,a total of doubt 57 Ampc enzyme-producing strains were found form260 strains in clinic,and 51 strains was positive among 57 strains using the three dimensional experimental detection.Among AmpC enzyme-producing Klebsiella pneumonia,DHA was majority and accounted for 90%,and there were only very few divides an inheritance MIX accounted for 6%,FOX for 2% and ACC for 2%.The 15 medicines were used to analyze drug resistance of Ampc enzyme-producing Klebsiella pneumonia.51 strains Klebsiella pneumonia′s sensitivity to the imipenem was 98.1percent,the drug resistance to the cefoxitinis being 100 percent,third generation cephalosporin′s drug resistance being over 70 percent.Conclusion The main genotype Ampc enzyme-producing Klebsiella pneumonia is DHA,and is multiple drug resistance in our hospital.