A molecular epidemiology study on nosocomial infection caused by ESBLs and AmpC-producing klebsiella pneumoniae

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A molecular epidemiology study on nosocomial infection caused by ESBLs and AmpC-producing klebsiella pneumoniae

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- A molecular epidemiology study on nosocomial infection caused by ESBLs and AmpC-producing klebsiella pneumoniae
- Journal of Chongqing Medical University Vol. 35, Issue 2, Pages: 304-308(2010)
- 作者机构：
  
  1. 重庆医科大学附属第一医院传染病寄生虫病研究所
  2. 第三军医大学西南医院药学部
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2010.02.009
  CLC： R450;R446.5
- Published：2010，
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[1]朱卫民,陈勇川,杨春,何光荣,黄文祥,郑行萍.产ESBLs和AmpC肺炎克雷伯菌医院感染分子流行病学研究[J].重庆医科大学学报,2010,35(02):304-308.

ZHU Wei-min, et al. A molecular epidemiology study on nosocomial infection caused by ESBLs and AmpC-producing klebsiella pneumoniae. [J]. Journal of Chongqing Medical University 35(2):304-308(2010)
[1]朱卫民,陈勇川,杨春,何光荣,黄文祥,郑行萍.产ESBLs和AmpC肺炎克雷伯菌医院感染分子流行病学研究[J].重庆医科大学学报,2010,35(02):304-308. DOI： 10.13406/j.cnki.cyxb.2010.02.009.

ZHU Wei-min, et al. A molecular epidemiology study on nosocomial infection caused by ESBLs and AmpC-producing klebsiella pneumoniae. [J]. Journal of Chongqing Medical University 35(2):304-308(2010) DOI： 10.13406/j.cnki.cyxb.2010.02.009.

摘要

目的:研究调查临床分离的120株非重复肺炎克雷伯菌中产超广谱β-内酰胺酶（Extended spectrumβ-lactamases

ESBLs）和头孢菌素酶（Ampler class Cβ-lactamase

AmpC）菌株的发生率

以及ESBLs和AmpC的表型及基因型。方法:采用美国国家临床实验室标准委员会规定的ESBLs表型

筛选和确证ESBLs的发生率。以分析性等电聚焦、接合实验确定ESBLs和AmpC菌株中酶的表型。以质粒为模板

用β-内酰胺酶通用引物、blaTEM、blaSHV及blaAmpC作PCR扩增

并以染色体为模板

用blaAmpC为引物作PCR扩增以确定酶的基因型。结果:120株非重复的肺炎克雷伯菌中

产β-内酰胺酶的有93株（77.5%）

其中15株产ESBLs（12.5%）

9株产AmpC（7.5%）。医院感染ESBLs阳性率（25.5%）明显高于院外感染株（3.7%）

所有产AmpC菌株均来自院内感染。所有菌株均对亚胺培南敏感。AmpC阳性菌株对β-内酰胺抗生素的耐药率高于AmpC阴性菌株。产ESBLs或AmpC的18株菌中有9株的编码基因可通过接合实验而转移。结论:肺炎克雷伯菌大多为产β-内酰胺酶菌株

其中产ESBLs和AmpC酶的频率较高

并常导致院内感染;其耐药质粒可通过接合转移给敏感菌

导致耐药性传播。

Abstract

Objective:To study the prevalence

phenotypes and genotypes of ESBLs and AmpC-producing 120 nonrepetitive clinical isolates of K.pneumoniae.Methods:The occurrence of phenotype producing ESBLs was screened and determined according to the National Committee for Clinical Laboratory Standards(NCCLS).The phenotypes ofβ-lactamase were studied by isolectric focusing and conjugation methods.The plasmid and genomic DNA extracted from the bacteria were used to determine genotype of theβ-lactamases by PCR with bla

blaTEM

blaSHV and blaAmpC-specific primers.~ts:The study showed that among 120 isolates

theβ-lactamaseproducing strains

ESBLs-producing and AmpC-producing strains were 93(77.5%)

15(12.5%)and 9(7.5%)isolates

respectively. The ESBLs-producing strains were much more frequently found in nosocomial isolates(25.5%)than that in community(3.7%).And all AmpC-producing strains were found in nosocomial isolates.None of them was resistant to imipenam.Furthermore

AmpC-producing strains were found to be more resistant to antibiotics than AmpC negative strains.The encoding genes could be transferred by conjugation and were found in 9 of 18 resistant strains producing both ESBLs and AmpC.Conclusion:A high incidence of ESBLs and AmpC -producing strains existed in K.pneumoniae.Theseβ-lactamase producing strains had been the main pathogens of nosocomial infection. Otherwise

that the gene encoding ESBLs and AmpC could be transferred to susceptible strains by conjugation leading to the resistance spreading abroad.

关键词

肺炎克雷伯菌超广谱β-内酰胺酶AmpC分子流行病学

Keywords

Klebsiella pneumoniaeExtended spectrumβ-lactamasesAmpCmolecular epidemiology

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