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The status of drug resistance and ampc gene expression in enterobacter cloacae

Chinese Medical Journal 2003年第8期116卷 1244-1247页

作者：周志慧李兰娟俞云松马亦林 Department of Infectious Diseases First Affiliated HospitalCollege of MedicineZhejiang University

Objective To investigate the status of the drug resistance and the ampc gene expression of enterobacter cloacae . Methods Disk diffusion tests were made for detecting the susceptibility of antimicrobial agents against enterobacter cloacae . ampc gene was amplified by polymerase chain reaction (PCR) and verified by DNA sequencing. ampc gene expression was analyzed according to antimicrobial agent sensitive phenotype. Results The sensitivity rates of 144 strains to imipenam,cefepime and cefoperazone/sulbactam were 98.61%,65.97% and 63.89%,respectively. The sensitivity rates of 144 strains to other antimicrobial agents were lower. Among the 144 strains 120 were found to be positive by PCR for ampc. The PCR product showed high homology to the GenBank ampc sequence. Stably derepressed strains,hyperinducible strains and unexpressing or lower level expressing strains accounted for 30.0% (36/120),37.5% (45/120),and 32.5% (39/120),respectively. Fifty-six out of 120 strains (46.67%) also produced extended spectrum β-lactamases (ESBLs). The hyperinducible strains were highly sensitive to all the antimicrobial agents except amoxicillin/clavulanic acid and cefuroxime,while the stably derepressed strains were only sensitive to imipenam and cefepime. However,sensitivity to cefepime decreased if the strains also produced ESBLs. Conclusions The durg resistant status of enterobacter cloacae is severe. Clearing out the expressive status of ampc gene will be helpful in selection of antimicrobial agents in the treatment of clinical infection.

关键词： enterobacter cloacae·drug resistance ampc gene·beta-lactamase ampc

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