【作者】 罗甫花；

【导师】 伍勇；

【作者基本信息】 中南大学 ， 临床检验诊断学， 2008， 硕士

【摘要】 目的研究肝移植术后感染阴沟肠杆菌的多重耐药基因和耐药性以及两者的相关联系,为防治术后感染提供依据。方法对40株从肝移植术后患者送检标本中分离到的阴沟肠杆菌进行琼脂稀释法药敏试验;采用三维试验法检测AmpC酶和ESBLs酶,EDTA-亚胺培南纸片增效法检测MBL酶;根据β内酰胺酶各种已知基因序列设计引物,进行聚合酶链反应及序列分析确定AmpC酶基因、ESBLs酶基因以及MBL酶的基因型分布。结果40株阴沟肠杆菌对多种抗生素耐药。22株ESBLs编码基因PCR结果阳性,经测序分别为SHV-2、CTX-M-3和CTX-M-9型ESBLs;14株ampD和ampC基因PCR扩增均呈阳性;2株金属酶IMP型基因PCR结果阳性;28株Ⅰ类整合酶基因PCR结果阳性。结论肝移植术后阴沟肠杆菌已呈现出多重耐药和高度耐药,阴沟肠杆菌产金属酶IMP基因在我国大陆为首次报道。更多还原

【Abstract】 Objective: To investigate multiple-drug-resistant genes antibiotic-resistance of Enterobacter cloacae strains after liver transplantation infection as well as their relationship and to provide evidence for prevention against and treatment of infect ion after liver transplantation.Methods: 40 strains of Enterobacter cloacae after liver transplantation infection were collected. The minimal inhibitory concentrations (MICs) of them were determined by standard agar dilution. Cephalosporinase (AmpC)β-lactamase and ESBLs were dectected by three-dimensional tests. MBL were detected by comparing the inhibition zones using imipenem containing EDTA. Genotypes and distribution were determined by polymerase chain reaction(PCR) with type-specific primers and sequence analysis.Results: Sensitivity test shows that they are resistant to the most antibiotics. 22 strains of them carried ESBLs gene: SHV-2, CTX-M-3 and CTX-M-9; 14 isolates carried ampD and ampC gene. 2 isolates carried Metallo-beta-lactamase gene IMP. 28 isolates carried class 1 integron.Conclusion: This investigation shows that there are multiple-drug-resistance and high degree of drug resistance on E. cloacae isolates in postoperative infection of liver transplation which genes of IMP in E. cloacae was firstly reported in China.更多还原