阴沟肠杆菌产AmpC酶菌和非产酶菌的耐药性研究

目的：探讨阴沟肠杆菌分布特征及产AmpC酶菌和非AmpC酶菌的耐药性。方法：对临床分离的158株阴沟肠杆菌分布科室、感染部位及对16种抗生素耐药性进行分析，并通过酶粗提物头孢西丁三维试验结合PCR法检测AmpC酶。结果：标本来源主要为患者的痰液、尿液、创口分泌物等，科室以重症监护室为多，感染部位以呼吸道为主，耐药性较高的抗生素为头孢西丁、头孢噻肟、头孢曲松等，158株阴沟肠杆菌中产AmpC酶菌株共33株，产AmpC酶阳性率占总菌株数20．9％，产AmpC酶菌株对各种抗生素的耐药率比不产AmpC酶的明显增高。结论：阴沟肠杆菌的耐药与产AmpC酶有关，治疗首选亚胺培南。

STUDY ON THE DRUG-RESISTANCE OF ENTEROBACTER CLOACAE PRODUCING AMPC AND NONPRODUCING AMPC ENZYME

Objective:To investigate the drug-resistance and distribution of 158 strai ns Enterobacter cloacae.Methods:Drug-resistance test to st rain s Enterobacter cloacae was detected in 16 kinds of antibiotics.The drug sens itiv ity tests was performed by the method of Kirby-Bauer paper-diffusion with the s tandard of NCCLS.AmpC enzyme was examined by cefoxitin three dimension test and PCR Amplification of ampC structure gene were studied.Results: The main sources of specimen were sputum,urine and wound secretion.The respirat ory tract was a major attribute of the development of Enterobacter cloacae. Enterobacter cloacae strain emerged mostly in the intensive care unites.The drug resi stance to cefoxitin,cefotaxime and ceftriaxone were high.Results: Of PCR amplification revealed that of 158 Enterobacter cloacae strains,33 strains had ampC structure gene which account for 20.9%.The drug resistance of Enterobacter cloacae p roducing AmpC enzyme were significantly higher than those of non-producing AmpC enzyme.Conclusions:The drug-resistance of Enterobacter clo acae was associated with AmpC enzyme.The best choice of treatment was imipenem .