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目的分析耐碳青霉烯类黏质沙雷菌(CRSM)的耐药机制及同源性,为临床合理用药提供依据。方法收集2014年-2015年烧伤病区CRSM菌株12株,分析其耐药机制及同源性。结果菌株对青霉素类、头孢菌素类和氨基糖苷类耐药率为100%,氟喹诺酮类和复方磺胺甲恶唑敏感率为100%,哌拉西林/他唑巴坦敏感率为91.7%;碳青霉烯类耐药率为91.7%;10株改良三维试验和改良Hodge试验阳性;11株Carba NP试验阳性;8株3-氨基苯硼酸试验阳性;2株EDTA抑制试验阳性;PCR显示9株携带bla_(KPC-2);2株携带bla_(IMP-1);未发现有合产碳青霉烯酶;PFGE显示有4株菌株为同一克隆株。结论本院烧伤病区患者分离的CRSM耐药机制以携带bla_(KPC-2)为主,并同时产ESBLs和AmpC酶;其次是携带bla_(IMP-1);有4株为同源株;应引起临床和实验室的重视。
Objective To analyze the resistance mechanism and homology of carbapenem - resistant serotonin (CRSM), and to provide a basis for clinical rational drug use. Methods Twelve CRSM strains from burn area were collected from 2014 to 2015, and their resistance mechanism and homology were analyzed. Results The susceptibilities of the strains to penicillins, cephalosporins and aminoglycosides were 100%. The sensitivity of fluoroquinolones and sulfamethoxazole was 100%. The sensitivity of piperacillin / tazobactam was 91.7%. Carbapenem resistance rate of 91.7%; 10 improved three-dimensional test and modified Hodge test positive; 11 Carba NP test positive; 8 3-aminophenylboronic acid test positive; 2 EDTA inhibitory test was positive; PCR 9 Strains carrying bla_ (KPC-2); 2 strains carrying bla_ (IMP-1); no co-producing carbapenemase; PFGE showed 4 strains of the same clone. CONCLUSION: The mechanism of CRSM resistance isolated from burn patients in this hospital is mainly associated with bla_ (KPC-2), ESBLs and AmpC enzymes, followed by bla_ (IMP-1), 4 homologous strains, Should cause clinical and laboratory attention.