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目的探讨主动外排泵在临床分离阴沟肠杆菌多重耐药的作用。方法收集、分离及鉴定阴沟肠杆菌,采用琼脂稀释法测定多重耐药泵抑制剂氰氯苯腙(carbonyl cyanldem-chlorophenylhydrazone,CCCP)应用前后,阴沟肠杆菌对头孢他啶、阿米卡星、阿奇霉素、左氧氟沙星和四环素5种抗生素的最小抑菌浓度(MIC)的变化。结果以上述5种抗生素为底物8,3株阴沟肠杆菌中,分别有303、61、9、32和28株在10μg/mL CCCP条件下MIC值降低4倍或4倍以上,其中有19株同时对3种及以上抗生素有明显外排作用。外排泵存在于耐药株和非耐药株中,但对耐药株的影响较大。结论主动外排系统广泛存在于临床分离阴沟肠杆菌中,是引起阴沟肠杆菌多重耐药的重要机制。外排泵抑制剂CCCP可增加阴沟肠杆菌对抗菌药物的敏感性。
Objective To explore the role of active efflux pump in the clinical isolation of Enterobacter cloacae multidrug resistance. Methods The Enterobacter cloacae were collected, isolated and identified. The levels of Enterobacter cloacae in ceftazidime, amikacin, azithromycin and levofloxacin were determined by agar dilution before and after the application of CCCP. And tetracycline five kinds of antibiotics minimum inhibitory concentration (MIC) changes. Results Among the 8 strains of Enterobacter cloacae, the MICs of 303, 61, 9, 32 and 28 strains were reduced by 4 times or more at 10μg / mL CCCP, of which 19 Strain at the same time on three or more antibiotics have significant efflux role. Excreted pump exists in the resistant and non-resistant strains, but the impact of resistant strains. Conclusion The active efflux system exists in clinical isolates of Enterobacter cloacae, which is an important mechanism of multidrug resistance of Enterobacter cloacae. CCCP, an efflux pump inhibitor, can increase the susceptibility of Enterobacter cloacae to antibiotics.