天津医药

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碳青霉烯类抗生素耐药的肺炎克雷伯菌IMP型金属β-内酰胺酶研究

李静1,胡巧娟2,胡志东3,田彬1,徐海茹1,谷秀梅1   

  1. 1. 天津医科大学总医院
    2. 天津医科大学总医院微生物免疫检验科
    3.
  • 收稿日期:2010-07-05 修回日期:2010-12-10 出版日期:2011-05-15 发布日期:2011-05-15
  • 通讯作者: 李静

Detection and Analysis for IMP Metallo-β-lactamase in carbapenem-resistant Klebsiella pneumoniae

  • Received:2010-07-05 Revised:2010-12-10 Published:2011-05-15 Online:2011-05-15

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摘要： 目的： 探讨天津医科大学总医院临床分离的肺炎克雷伯菌产金属酶的情况及对产金属酶菌株进行耐药性分析，为临床合理选用抗菌药物提供依据。方法： 收集142株临床分离肺炎克雷伯菌通过改良Hodge试验、改良三维试验检测其碳青霉烯酶，EDTA协同试验检测金属酶，PCR法扩增金属酶基因，用纸片法和VITEK2-Compact全自动微生物分析仪进行药物敏感性试验。结果： 142株肺炎克雷伯菌中检出2株产金属酶菌株，经PCR证实为产IMP型金属酶，2株产金属酶的菌株对氨曲南敏感，而对青霉素类、头孢菌素类、碳青霉烯类抗菌药物耐药。结论 ：天津地区已出现产金属酶肺炎克雷伯菌，该酶是引起肺炎克雷伯菌耐碳青霉烯类抗生素的主要原因。

关键词: 肺炎克雷伯菌, 碳青霉烯酶, 金属酶, PCR

Abstract: Objective: To investigate and analyse metallo-β-lactamases of Klebsiella Pneumonia in Tianjin Medical University General Hospital, for guiding the rational use of antibiotics therapy. Methods: One hundred and forty-two clinical strains of Klebsiella Pneumonia were collected , the modified Hodge test and the modified three-dimensional test were used to co-detect carbapenemase and the MBL encoding genes were amplified by PCR ;Kirby-Bauer method and VITEK2-Compact system were performed to detect the sensitivity of the antimicrobial agents against the Klebsiella Pneumoniae . Results: we found two metallo-beta-lactamase-producing strains in One hundred and forty-two clinical strains of Klebsiella Pneumonia, PCR indicated that the two strain carried IMPgenes. Aztreonam were sensitive to the Klebsiella pneumoniae metallo-beta-lactamase--producing strains, but carbapenems， penicillins and cephalosporins antibiotics were resisitant. Conclusions: It is already detected metallo-β-lactamases in Klebsiella pneumoniae in Tianjin. The production of enzyme is the main mechanisms of carbapenem-resistant in Klebsiella pneumoniae.

Key words: Klebsiella Pneumoniae, carbapenemases, metallo-beta-lactamases, PCR