中文摘要：

目的研究我院2012年碳青霉烯类非敏感阴沟肠杆菌耐药基因特点和分子流行病学特征。方法收集我院2012年阴沟肠杆菌268株,采用VITEK2鉴定并检测碳青霉烯类、头孢类、喹诺酮和氨基糖苷类抗生素MIC值;PCR扩增碳青霉烯酶、超广谱β-内酰胺酶（extended spectrum betalactamases,ESBLs）、喹诺酮、氨基糖苷类耐药基因和Ⅰ类整合子（Intl1）;脉冲场凝胶电泳（pulsed-field gel electrophoresis,PFGE）进行分子流行病学分析。结果 2（4%）株菌携带blaIMP-8,分别有41（82%）、41（82%）、37（74%）、20（40%）株菌ESBLs、喹诺酮、氨基糖苷类耐药基因和Intl1阳性;2株blaIMP-8阳性的菌株均携带ESBLs、喹诺酮和氨基糖苷类耐药基因;41株ESBLs阳性的菌株,分别有40（97.6%）和33（80.5%）株菌携带喹诺酮和氨基糖苷类耐药基因。PFGE结果显示碳青霉烯类非敏感阴沟肠杆菌分为21个不同型别。结论我院喹诺酮和氨基糖苷类耐药基因在碳青霉烯类非敏感阴沟肠杆菌中高度流行,同一菌株同时表达多种耐药基因,分子流行病学显示具有克隆多样性。

英文摘要：

Objective To investigate the characterization of resistance genes and molecular epidemiology of carbapenem-nonsusceptible（ CNS） Enterobacter cloacae（ E. cloacae） isolates in our hospital.Methods Antimicrobial susceptibility of 50 non-duplicated CNS E. cloacae isolates collected in 2012 was analyzed by VITEK2 Compact. Carbapenemase genes,extended spectrum β-lactamase（ ESBL） genes,quinolone resistance determinants（ QRDs）,aminoglycoside resistance determinants（ ARDs） and class Ⅰintegrin（ Intl1） were examined by PCR. Clonal relatedness was determined by pulsed-field gel electrophoresis（ PFGE）. Results Of the 50 isolates,2（ 4%） harbored carbapenemase gene blaIMP-8,and 41（ 82%）carried ESBLs. There were 41（ 82%） ESBL-positive isolates,41（ 82%） QRD-positive isolates,37（ 74%）ARD-positive isolates,and 20（ 40%） Intl1-positive isolates. The 2 blaIMP-8-positive isolates harbored ESBLs,QRD genes and ARD genes. Of the 41 ESBL-positive isolates,40（ 97. 6%） were QRD-positive,and 33（ 80. 5%） were ARD-positive. PFGE showed that the 50 CNS E. cloacae isolates were devided into 21 different types. Conclusion QRD and ARD genes are highly prevalent among the CNS E. cloacae isolates in our hospital. Multi-drug resistant genes are co-expressed in the same isolates. Molecular epidemiology analysis reveals donal diversities in these 50 strains.