| 肠杆菌科细菌产碳青霉烯酶菌株的检测及同源性的研究 |
| Alternative Title | The study of carbapenemases in Enterobacteriaceae and homplogy of Carbapenems-resistant strains
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| 张成宪 |
| Thesis Advisor | 金凤玲
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| 2013-05-17
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 肠杆菌科细菌
碳青霉烯酶
改良Hodge实验
PCR
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| Abstract | 目的 研究我院肠杆菌科细菌产碳青霉烯酶菌株的基因型及其同源性。为临床实验室常规检测及预防控制肠杆菌科细菌产碳青霉烯酶菌株的发生及流行提供基础资料。
方法 使用WHONET5.5软件对兰大一院2009年6月—2012年6月间分离的肠杆菌科细菌的药敏实验结果、临床分布及耐药现状等资料进行统计，分析其耐药现状及临床分布情况，筛选出30株碳青霉烯类抗生素敏感性下降的肠杆菌科细菌。30株碳青霉烯类抗生素敏感性下降的肠杆菌科细菌采用改良Hodge试验表型检测碳青霉烯酶、EDTA双纸片协同试验筛选金属酶。30株碳青霉烯类抗生素敏感性下降的肠杆菌科细菌用PCR检测blaNDM-1、blaKPC、blaSME、blaIMP、blaVIM基因，对PCR阳性菌株分别做Rep-PCR实验研究耐药菌株的同源性。
结果 我院2009年6月—2012年6月间分离的肠杆菌科细菌中碳青霉烯类抗生素敏感性下降的肠杆菌科细菌30株，标本分别来自ICU、普外科、泌尿科、神经内科等科室，其中21株改良Hodge试验阳性，23株EDTA双纸片协同试验阳性。PCR扩增结果显示14株菌携带blaNDM-1，其中肺炎克雷伯菌12株，产酸克雷伯菌和阴沟肠杆菌各1株。未扩增出blaKPC、blaSME、blaIMP、blaVIM的目的基因条带。Rep-PCR实验结果显示，我院微生物实验室所分离的12株产NDM-1肺炎克雷伯菌为两组克隆菌株。
结论 NDM-1型碳青霉烯酶为我院肠杆菌科细菌产碳青霉烯酶的主要型别，且已在我院ICU病房中局部流行。在16株耐碳青霉烯类抗生素耐药或中介的肠杆菌科细菌中未检出目的基因，其耐药机制有待于进一步的研究。 |
| Other Abstract | OBJECTIVE: In order to provide basic datum to prevent and control of the occurrence and epidemic of Carbapenems-resistant Enterobacteriaceae strains and clinical laboratories routine tests, we make a study about the main mechanism of carbapenems-resistance Enterobacteriaceae and the prevalence of carbapenemase in our hospital.
METHODS: Thirty isolated Enterobacteriaceae decreasing susceptibility to carbapenem antibiotics were collected in our hospital from June 2010 to June 2012. They were identified by Vitek2 Compact. Susceptibility testing of bacteria were carried out by K-B test.. The phenotype of carbapenemase was selected by Modified Hodge test and EDTA double-disk synergy test. The blaNDM-1, blaKPC, blaIMP, blaVIM, blaSME were detected by PCR. The PCR-positive strains were performed to analyze the homology of isolates by Rep-PCR.
RESULTS: Thirty multi-drug resistant strains were isolated, which came from ICU (22), General surgery (6), Urology (1), Neurology (1). Twenty one strains were positive in Modified Hodge test，twenty three strains were positive in EDTA double-disk synergy test. PCR amplification results showed that 14 isolates produced NDM-1 type carbapenemase, of which 12 Klebsiella pneumoniae, 1 Klebsiella oxytoca and 1 Enterobacter cloacae. blaKPC, blaIMP, blaVIM,blaSME gene were negative in all of the thirty isolates.
CONCLUSION: NDM-1 type carbapenemases is the major type of carbapenemases in our hospital. There was a small-scale epimedics in ICU. The further research should be given to the carbapenem antibiotics resistance mechanisms. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223758
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
张成宪. 肠杆菌科细菌产碳青霉烯酶菌株的检测及同源性的研究[D]. 兰州. 兰州大学,2013.
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