论文部分内容阅读
目的了解本院弗氏柠檬酸杆菌临床分布及对常用抗生素耐药情况,探讨本院氨基糖苷类抗生素耐药相关酶-16S rRNA甲基化酶基因型分布,为临床用药提供参考。方法收集本院分离的198株弗氏柠檬酸杆菌,统计微生物室该菌抗生素耐药情况;PCR技术扩增16S rRNA甲基化酶基因armA、rmtA、rmtB、rmtC、rmtD和npmA,对阳性表达率进行分析。结果 198株弗氏柠檬酸杆菌大多来自于肝胆外科、神经外科和ICU科室的胆汁、痰液和尿液标本。弗氏柠檬酸杆菌对二、三代头孢具有较高的敏感性;对氨基糖苷类抗生素奈替米星、庆大霉素和阿米卡星耐药率依次为17.68%、14.65%和10.61%;对碳青霉烯类抗生素美罗培南和亚胺培南几乎全部敏感。PCR结果显示198株菌株中有29株携带armA基因,21株携带rmtB基因,其余基因未检出。结论本院弗氏柠檬酸杆菌临床耐药控制情况尚可,无明显的高耐药率现象,临床应严格按照实验室药敏结果选择相应抗生素治疗;近年氨基糖苷类抗生素耐药率上升,本院中只流行armA和rmtB基因型。
Objective To understand the clinical distribution of Citrobacter freundii and its resistance to commonly used antibiotics in our hospital and to explore the distribution of aminoglycoside resistance-related enzyme -16S rRNA methylase genotypes in our hospital and provide a reference for clinical use. Methods A total of 198 strains of Citrobacter freundii isolated in our hospital were collected and the antibiotic resistance of the bacteria was counted. The 16S rRNA methylase gene armA, rmtA, rmtB, rmtC, rmtD and npmA were amplified by PCR, Rate analysis. Results 198 strains of Citrobacter freundii were mostly from the bile, sputum and urine specimens of hepatobiliary surgery, neurosurgery and ICU departments. Citrobacter freundii was highly sensitive to second and third generation cephalosporins. The resistance rates to netilmicin, gentamicin and amikacin of aminoglycoside antibiotics were 17.68%, 14.65% and 10.61%, respectively. Nearly all of the carbapenem-resistant meropenem and imipenem are susceptible. PCR results showed that 29 strains of 198 strains carried armA gene, 21 strains carried rmtB gene, and the other genes were not detected. Conclusion The clinical drug-resistant control of Citrobacter freundii in our hospital is still acceptable. There is no obvious phenomenon of high drug resistance. In clinical practice, antibiotics should be selected according to the results of laboratory susceptibility testing. In recent years, the rate of aminoglycoside antibiotics increased. Only armA and rmtB genotypes were hospitalized.