张家口地区木糖氧化无色杆菌耐药性的相关基因分析

目的：了解张家口地区木糖氧化无色杆菌耐药性的相关基因的基因型别,为临床合理使用抗生素提供实验依据。方法：应用改良三维试验法筛选耐β-内酰胺类药物的菌株,再结合PCR技术和序列测定检测耐药菌ESBLs和AmpC酶的基因型别,最后进行统计学分析。结果：2010年12月~2011年12月本地区临床分离的48株木糖无色杆菌菌株中有32株对β-内酰胺类药物耐药,检出率高达66.7%,其中14株单产ESBLs,5株单产AmpC酶,9株同时产ESBLs和AmpC酶,4株为未知型菌株;筛选出的耐药菌中有24株PCR结果阳性,分属于不同耐药基因型并发现存在多重耐药基因。ESBLs以TEM型检出率最高,均为TEM-1亚型;AmpC酶检出率也较高,均为DHA-1型;多重耐药基因TEM＋CTX-M-1＋AmpC检出率最高。结论：张家口地区木糖氧化无色杆菌的耐药现象严重,临床上应严格掌握头抱菌素类药物的使用以取得更好的治疗效果。

Analysis of Drug Resistance Genes of Achromobacter Xylosoxidans in Zhangjiakou

Objective： To investigate the genetic type of drug resistance genes of Achromobacter xylosoxidans in Zhangjiakou and provide experimental references for clinical use of antibiotics. Methods： Modified three-dimensional test was used to screen the strain resistance to β-lactam drugs, then PCR and sequence analysis were used to test genetic type of ESBLs and AmpC. Results： Among 48strains of Achromobacter xylosoxidans isolated in Zhangjiakou hospital from Dec 2010 to Dec 2011, 32 strains（66.7%） were resistant toβ-lactam drugs, 14 produced ESBLs, 5 produced AmpC, 9 produced both ESBLs and AmpC, 4 were unknown strain. 24 strain PCR results were positive, and belonged to different gene types. Multidrug resistance were found. TEM type was the highest ESBLs, and all were TEM-1 subtype; AmpC detection rate was higher, all belonged to DHA-1 type; TEM＋CTX-M-1＋AmpC was the highest Multidrug resistance type. Conclusion： The percentage of Achromobacter xylosoxidans resistance to β-lactam drugs were serious in hospitals of Zhangjiakou, the use of head embrace rhzomorph drugs should be strictly controlled in order to obtain more favorable curative effect.