资源描述：
《肺炎克雷伯菌臭鼻亚种产B2内酰胺酶的.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、·338·ChinJNosocomiolVol.14No.32004·论 著·肺炎克雷伯菌臭鼻亚种产B2内酰胺酶的分类检测及耐药性明德松(泉州市第一医院,福建泉州362000)摘要:目的 研究肺炎克雷伯菌臭鼻亚种(Koz)所产各种B2内酰胺酶(B2lase)分布及其耐药性。方法 采用多底物纸片法、ESBLs确认试验、AmpC酶检测法检测36株Koz所产各种B2lase,采用琼脂扩散法分析其耐药性。结果 (1)36株KozB2lase检出率为69.4%,其中单独产广谱酶、青霉素酶、ESBLs分别为
2、1、1、12株,产AmpC酶总数11株(30.5%),ESBLs总数22株(61.1%),未检出碳青酶烯酶;产复合酶11株(30.5%),青霉素酶+诱导型AmpC酶1株,诱导型AmpC酶+ESBLs7株,持续高产AmpC酶+ESBLs3株;(2)22株产ESBLs菌株中,CAZ,ATM,CTX检出率分别68.2%、77.3%、95.5%;(3)非产酶Koz对12种抗生素均敏感;25株产B2内酰胺酶Koz中,非产ESBLs菌株对PRL、GN、SXT多数耐药,青霉素酶+诱导型AmpC酶、ESBLs+
3、诱导型AmpC酶产酶菌株和产ESBLs菌株对亚胺培南、头孢哌酮ö舒巴坦较敏感,对其他抗生素均有不同程度的较高耐药率,持续高产AmpC酶+ESBLs仅对亚胺培南敏感。结论 36株Koz产B2lase总检出率很高,产4种酶,以AmpC酶、ESBLs为主,未检出碳青酶烯酶;复合产酶是其主要产酶形式之一,臭鼻克雷伯菌所产ESBLs的检出率以CTX最高;不同产酶菌株耐药谱不同,持续高产AmpC酶+ESBLs仅对亚胺培南敏感。关键词:肺炎克雷伯菌臭鼻亚种;B2内酰胺酶;分类;耐药性中图分类号:R378.99
4、文献标识码:A文章编号:100524529(2004)0320338203AntimicrobialSusceptibility,ClassificationandDistributionoftheB-LactamasesProducedbyKlebsiellapneumoniaesubspozaenaeMINGDe2song(TheFirstHospitolofQuanzhou,Quanzhou,Fujian362000,China)Abstract:OBJECTIVETostudythean
5、timicrobialsusceptibility,classificationanddistributionoftheB2lacta2masesproducedbyKlebsiellapneumoniaesubspozaenae(Koz).METHODSThirtysixB2lactamasesproducedbyKozweredetectedwithamulti2disktest[(synergytest,antagonistictestfortheinducibleAmpCB2lactam
6、ases(IABLs)),AmpCB2lactamases(ABLs)phenotypetestandextended2spectrumB2lactamases(ESBLs)comfir2menttest,thesusceptibilityofantimicrobialagents.RESULTS(1)Twentyfiveof36strainsproducedtheB2lac2tamases(69.4%);1strainproducedbroad2spectrumB2lactamasesorpe
7、nicillinases,12strainsproducedESBLsalone,11strainsproducedABLs30.5%,8strainsproducedIABLs(25.0%),1strainproducedpenicillinases+IABLs;7strainsproducedESBLs+IABLs;3strainsproducedESBLs+highproducedABLs.Noneproducedcarbapenem2hydrolyzingB2lactamases(CHB
8、Ls);(2)Gmong22strainsproducingESBLs,thesensitivitiestotheceftazidime,aztreonamandcefotaximewere68.2%,77.3%and95.5%,respectively;(3)thestrainsunproduc2ingB2lactamasesweresusceptibletoallantibiotics;strainsproducingB2lactamases,themajorityofstrainsunpr
