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目的分析肺炎克雷伯菌产头孢菌素酶(AmpC酶)的耐药表型与基因型,了解其耐药特征和流行趋势。方法对温州医科大学附属苍南医院和永嘉县人民医院呼吸内科2015年7~12月住院患者下呼吸道感染样本中分离的97株肺炎克雷伯菌,作产AmpC酶耐药表型与基因型分析,采用VITEK-60型全自动细菌鉴定仪鉴定细菌;采用头孢西丁纸片扩散法筛选产AmpC酶菌株;采用三维试验确证产AmpC酶菌株;采用PCR和DNA测序检测分析AmpC酶基因型别。结果 97株肺炎克雷伯菌经头孢西丁敏感试验选出疑产AmpC酶菌株21株,经三维试验确证产AmpC酶菌株有15株,21株疑产AmpC酶菌株经PCR检测有15株菌株显示阳性,经DNA测序证实均为DHA-1型AmpC酶。结论产AmpC酶的肺炎克雷伯菌表型与基因型不完全相同,二者的结果有一定的关联性但同时存在差异,应以PCR扩增结果为准。
Objective To analyze the phenotypes and genotypes of cephalosporins (AmpCases) produced by Klebsiella pneumoniae, and to understand its resistance characteristics and epidemiological trends. Methods 97 strains of Klebsiella pneumonia isolated from samples of lower respiratory tract inpatients from July 2015 to December 2015 in Cangnan Hospital and Yongjia People’s Hospital of Wenzhou Medical University were enrolled in this study. The antibiotic resistance phenotype and genotype of AmpC , Using VITEK-60 automatic bacterial identification instrument identification of bacteria; using cefoxitin disk diffusion screening AmpC enzyme producing strains; using three-dimensional test confirmed AmpC enzyme producing strains; PCR and DNA sequencing detection AmpC enzyme genotypes. Results 97 strains of Klebsiella pneumoniae were selected 21 strains of AmpC β-lactamase strains by cefoxitin susceptibility test. 15 strains of AmpC β-lactamase strains were confirmed by three-dimensional test. Among 21 strains of AmpC β-lactamase strains, 15 strains were detected by PCR Showed positive, confirmed by DNA sequencing were DHA-1 type AmpC enzyme. Conclusion The phenotypes and genotypes of Klebsiella pneumoniae producing AmpC β-lactamase are not completely the same. The results of the two tests are related to each other but there are differences at the same time. PCR amplification should prevail.