臨床分離的耐碳青霉烯類腸桿菌科細菌的研究進展_《華西醫學》

作者：

劉雅 ,  康梅

四川大學華西醫院實驗醫學科（成都，610041）;

關鍵詞：

腸桿菌科細菌碳青霉烯類抗生素耐藥

DOI：

10.7507/1002-0179.20130199

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

腸桿菌科細菌是醫院感染的重要病原菌，分離率高。碳青霉烯類抗生素對絕大多數β-內酰胺酶穩定，抗菌譜廣，抗菌活性強。然而隨著碳青霉烯類抗生素的大量使用，全球許多地區出現了碳青霉烯類耐藥的腸桿菌科細菌報道，本文就其流行病學現狀、耐藥機制及檢測方法作一綜述。

引用本文： 劉雅,康梅. 臨床分離的耐碳青霉烯類腸桿菌科細菌的研究進展. 華西醫學, 2013, 28(4): 631-636. doi: 10.7507/1002-0179.20130199 復制

1.	洪秀華, 劉運德, 李向陽, 等. 臨床微生物學檢驗[M]. 北京: 中國醫藥科技出版社, 2010: 304-306.
2.	Birgy A, Bidet P, Genel N, et al. Phenotypic screening of carbapenemases and associated β-lactamases in carbapenem-resistant enterobacteriacease[J]. J Olin Microbiol, 2012, 59(4): 1295-1302.
3.	Naas T, Vandel L, Sougakoff W, et al. Cloning and sequence analysis of the gene for a carbapenem-hydrolyzing class A beta-lactamase, Sme-1, from Serratia marcescens S6[J]. Antimicrob Agents Chemother, 1994, 38(6): 1262-1270.
4.	Queenan AM, Torres-Viera C, Howard S. Gold, et al. SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains[J]. Antimicrob Agents Chemother, 2000, 44(11): 3035-3039.
5.	Yang Y, Wu P, Livermore D. Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates[J]. Antimicrob Agents Chemotherapy, 1990, 34: 755-758.
6.	Borgia S, Lastovetska O, Richardson D, et al. Outbreak of carbapenem-resistant enterobacteriaceae containing blaNDM-1, Ontario, Canada[J]. Clin Infect Dis, 2012, 55(11): 109-117.
7.	Adlera A, Carmelia BY. Dissemination of the Klebsiella pneumonia carbapenemase in the health care settings: tracking the trails of an elusive offender[J]. mBio, 2011, 2(6): 280-291.
8.	Curcio DJ. Antibiotic prescription in intensive care units in Latin America[J]. Revista Argentina de Microbiología, 2011, 43: 203-211.
9.	Pfeifer Y, Schlatterer K, Engelmann E, et al. Emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in German hospitals[J]. Antimicrob Agents Chemother, 2012, 56(4): 2125-2128.
10.	Agodi A, Voulgari E, Barchitta M, et al. Containment of an outbreak of KPC-3-producing klebsiella pneumoniae in Italy[J]. J Clin Microbiol, 2011, 49(11): 3986-3989.
11.	Leverstein-van Hall MA, Stuart JC, Voets GM, et al. Carbapenem-resistant Klebsiella pneumoniae following foreign travel[J]. Ned Tijdschr Geneeskd, 2010, 154(37): 1736.
12.	Us E, Tekeli A, Arikan AO, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae strains isolated between 2004-2007 in Ankara University hospital, Turkey[J]. Mikrobiyol Bul, 2010, 44(1): 1-10.
13.	Shen P, Wei ZQ, Jiang Y, et al. Novel genetic environment of the carbapenem-hydrolyzing β-lactamase KPC-2 among enterobacteriaceae in China[J]，Antimicrob Agents Chemotherapy, 2009 , 53(10): 4333-4338.
14.	Roh KH, Lee CK, Sohn JW, et al. Isolation of a Klebsiella pneumoniae isolate of sequence type 258 producing KPC-2 carbapenemase in Korea[J]. Korean J Lab Med, 2011, 31(4): 298-301.
15.	Saidani M, Hammami S, Kammoun A, et al. Emergence of carbapenem resistant Enterobacteriaceae producing OXA-48 carbapenemase in Tunisia[J]. J Med Microbiol, 2012, 61(12): 1746-1749.
16.	Datta P, Gupta V, Garg S, et al. Phenotypic method for differentiation of carbapenemases in enterobacteriaceae: study from north India[J]. Indian J Pathol Microbiol, 2012, 55(3): 357-360.
17.	Arpin C, Noury P, Boraud D, et al. NDM-1-producing Klebsiella pneumoniae resistant to colistin in a French community patient without history of foreign travel[J]. Antimicrob Agents Chemother, 2012, 56(6): 3432-3434.
18.	Gaynes RP, Culver DH. Resistance to imipenem among selected gram-negative bacilli in the United States[J]. Infect Control Hosp Epidemiol, 1992, 13(1): 10-14.
19.	Rhomberg PR, Jones RN, et al. Summary trends for the meropenem yearly susceptibility test information collection program: a 10-year experience in the United States(1999-2008)[J]. Diagn Microbiol Infect Dis , 2009, 65(4): 414-426.
20.	Hidron AI, Edwards JR, Patel J, et al. NHSN annualupdate: antimicrobial-resistant pathogens associated with ealthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention[J]. Infect Con Hosp Epidemio, 2008, 29(11): 996-1011.
21.	肖永紅, 王進, 趙彩云, 等. 2006-2007年Mohnarin細菌耐藥監測[J]. 中華醫院感染學雜志, 2008, 18(8): 1051-1056.
22.	李麗, 田磊, 陳中舉, 等. 衛生部全國細菌耐藥監測網2010年中南地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 940-947.
23.	徐修禮, 周珊.衛生部全國細菌耐藥監測網2010年西北地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 925-931.
24.	張智潔, 王軍. 衛生部全國細菌耐藥監測網2010年東北地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 948-975.
25.	馬序竹, 鄭波.衛生部全國細菌耐藥監測網2010年北京地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 919-924.
26.	肖書念, 卓超, 鐘南山. 衛生部全國細菌耐藥監測網2010年廣東地區細菌耐藥性監測[J].中國臨床藥理學雜志, 2011, 27(12): 965-971.
27.	張緯博, 孫景勇, 倪語星. 衛生部全國細菌耐藥監測網2010年華東地區細菌耐藥性監測[J].中國臨床藥理學雜志, 2011, 27(12): 959-964.
28.	楊央, 呂火祥, 胡慶豐, 等. 1456株連續分離的肺炎克雷伯菌臨床分布及耐藥性分析[J].中國衛生檢驗雜志, 2010, 20(9): 2232-2234.
29.	蔡佳昌. 腸桿菌科細菌對碳青霉烯類抗生素耐藥機制研究[D]. 浙江：浙江大學博士學位論文. 2010.
30.	Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing β-Lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae[J]. Antimicrob Agents Chemotherapy, 2001, 45(4): 1151-1161.
31.	Miriagou V, Tzouvelekis LS, Rossiter S, et al. Imipenem resistance in a salmonella clinical strain due to plasmid-mediated class a carbapenemase KPC-2[J]. Antimicrob Agents Chemotherapy, 2003, 47(4): 1297-300.
32.	Bratu S, Landman D, Alam M, et al. Detection of KPC carbapenem-hydrolyzing enzymes in enterobacterspp. from Brooklyn, New York[J]. Antimicrob Agents Chemother , 2004, 48(12): 4793-4799.
33.	Woodford N, Tierno PM, Young JrK, et al. Outbreak of klebsiella pneumoniae producing a new carbapenem-hydrolyzing Class A-Lactamase, KPC-3, in a New York Medical Center[J]. Antimicrob Agents Chemother, 2005, 49(2): 776-778.
34.	Landman D, Babu E, Patel JB, et al. Transmission of carbapenem-resistant pathogens in New York City hospitals: progress and frustrationm[J]. Antimicrob Chemother, 2012, 67(6): 1427-1431.
35.	Landman D, Bratu S, Kochar S, et al. Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY[J]. J Antimicro Chemother, 2007, 60(1): 78-82.
36.	Gupta N, Limbago BM, Patel JB, et al. Carbapenem-resistant enterobacteriaceae: epidemiology and prevention[J]. Clin Infect Dis, 2011, 53(1): 60-67.
37.	Mathers AJ, Cox HL, Kitchel B, et al. Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals intergenus kpc carbapenemase transmission through a promiscuous plasmid[J]. mBio, 2011, 2(6): 204-211 .
38.	Osano E, Arakawa Y, Wacharotayankun R, et al. Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance[J]. Antimicrob Agents Chemother, 1994, 38(1): 71-78.
39.	Miriagou V, Tzelepi E, Gianneli D, et al. Escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-β-Lactamase VIM-1[J]. Antimicrob Agents Chemother, 2003, 47(1): 395-397.
40.	Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India[J]. Antimicrob Agents Chemother, 2009 , 53(12): 5046-54.
41.	Deshpande LM, Mendes RE, Castanheira M, et al. Dissemination of NDM-1-producing enterobacteriaceae in India [abstract C2-701]. 50th Interscience Conference on Antimicrobial Agents and Chemotherapy[M]. Boston: American Society for Microbiology, 2010.
42.	Poirel L, Héritier C, Tolün V, et al. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother J, 2004, 48(1) : 15-22 .
43.	Cre´ met L, Bourigault CL, Lepelletier D, et al. Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora [J]. Antimicrob Chemother, 2012, 67 (4): 1041-1043.
44.	李俐, 蔣燕群.大腸埃希菌和肺炎克雷伯菌外膜蛋白與耐藥機制的研究進展[J]. 上海交通大學學報·醫學版, 2010, 30(11): 1433-1436.
45.	Sureda LG, Dome´nech-Sa´nchez A, Barbier M, et al. OmpK26, a novel porin associated with carbapenem resistance in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother, 2011, 55(10) : 4742-4747.
46.	Neuwirth C, Siébor E, Duez JM, et al. Imipenem resistance in clinical isolates of Proteus mirabilis associated with alterations in penicillin-binding proteins[J]. Antimicrob Agents Chemother, 1995, 36 (2): 335-342.
47.	Lee K, Lim YS, Yong D, et al. Evaluation of the Hodge test and the imipenem-EDTA double disk synergy test for differentiating metallo-β- lactamase-producing isolates of Pseudomonas spp and Acinetobacter spp[J]. J Clin Microbiol, 2003, 41(10): 4623-4629.
48.	McGettigan SE, Andreacchio K, Edelstein PH. Specificity of ertapenem susceptibility screening for detection of Klebsiella pneumoniae carbapenemases[J]. J Clin Microbiol, 2009, 47(3): 785-786.
49.	Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in enterobacteriaceae[J]. J Clin Microbiol, 2007, 45(8): 2723-2725.
50.	Hindiyeh M, Smollan G, Grossman Z, et al. Rapid detection of blaKPC carbapenemase genes by internally controlled real-time pcr assay using[J]. J Clin Microbiol, 2011, 49(7) : 2480-2484 .

1. 　洪秀華, 劉運德, 李向陽, 等. 臨床微生物學檢驗[M]. 北京: 中國醫藥科技出版社, 2010: 304-306.
2. 　Birgy A, Bidet P, Genel N, et al. Phenotypic screening of carbapenemases and associated β-lactamases in carbapenem-resistant enterobacteriacease[J]. J Olin Microbiol, 2012, 59(4): 1295-1302.
3. 　Naas T, Vandel L, Sougakoff W, et al. Cloning and sequence analysis of the gene for a carbapenem-hydrolyzing class A beta-lactamase, Sme-1, from Serratia marcescens S6[J]. Antimicrob Agents Chemother, 1994, 38(6): 1262-1270.
4. 　Queenan AM, Torres-Viera C, Howard S. Gold, et al. SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains[J]. Antimicrob Agents Chemother, 2000, 44(11): 3035-3039.
5. 　Yang Y, Wu P, Livermore D. Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates[J]. Antimicrob Agents Chemotherapy, 1990, 34: 755-758.
6. 　Borgia S, Lastovetska O, Richardson D, et al. Outbreak of carbapenem-resistant enterobacteriaceae containing blaNDM-1, Ontario, Canada[J]. Clin Infect Dis, 2012, 55(11): 109-117.
7. 　Adlera A, Carmelia BY. Dissemination of the Klebsiella pneumonia carbapenemase in the health care settings: tracking the trails of an elusive offender[J]. mBio, 2011, 2(6): 280-291.
8. 　Curcio DJ. Antibiotic prescription in intensive care units in Latin America[J]. Revista Argentina de Microbiología, 2011, 43: 203-211.
9. 　Pfeifer Y, Schlatterer K, Engelmann E, et al. Emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in German hospitals[J]. Antimicrob Agents Chemother, 2012, 56(4): 2125-2128.
10. 　Agodi A, Voulgari E, Barchitta M, et al. Containment of an outbreak of KPC-3-producing klebsiella pneumoniae in Italy[J]. J Clin Microbiol, 2011, 49(11): 3986-3989.
11. 　Leverstein-van Hall MA, Stuart JC, Voets GM, et al. Carbapenem-resistant Klebsiella pneumoniae following foreign travel[J]. Ned Tijdschr Geneeskd, 2010, 154(37): 1736.
12. 　Us E, Tekeli A, Arikan AO, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae strains isolated between 2004-2007 in Ankara University hospital, Turkey[J]. Mikrobiyol Bul, 2010, 44(1): 1-10.
13. 　Shen P, Wei ZQ, Jiang Y, et al. Novel genetic environment of the carbapenem-hydrolyzing β-lactamase KPC-2 among enterobacteriaceae in China[J]，Antimicrob Agents Chemotherapy, 2009 , 53(10): 4333-4338.
14. 　Roh KH, Lee CK, Sohn JW, et al. Isolation of a Klebsiella pneumoniae isolate of sequence type 258 producing KPC-2 carbapenemase in Korea[J]. Korean J Lab Med, 2011, 31(4): 298-301.
15. 　Saidani M, Hammami S, Kammoun A, et al. Emergence of carbapenem resistant Enterobacteriaceae producing OXA-48 carbapenemase in Tunisia[J]. J Med Microbiol, 2012, 61(12): 1746-1749.
16. 　Datta P, Gupta V, Garg S, et al. Phenotypic method for differentiation of carbapenemases in enterobacteriaceae: study from north India[J]. Indian J Pathol Microbiol, 2012, 55(3): 357-360.
17. 　Arpin C, Noury P, Boraud D, et al. NDM-1-producing Klebsiella pneumoniae resistant to colistin in a French community patient without history of foreign travel[J]. Antimicrob Agents Chemother, 2012, 56(6): 3432-3434.
18. 　Gaynes RP, Culver DH. Resistance to imipenem among selected gram-negative bacilli in the United States[J]. Infect Control Hosp Epidemiol, 1992, 13(1): 10-14.
19. 　Rhomberg PR, Jones RN, et al. Summary trends for the meropenem yearly susceptibility test information collection program: a 10-year experience in the United States(1999-2008)[J]. Diagn Microbiol Infect Dis , 2009, 65(4): 414-426.
20. 　Hidron AI, Edwards JR, Patel J, et al. NHSN annualupdate: antimicrobial-resistant pathogens associated with ealthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention[J]. Infect Con Hosp Epidemio, 2008, 29(11): 996-1011.
21. 　肖永紅, 王進, 趙彩云, 等. 2006-2007年Mohnarin細菌耐藥監測[J]. 中華醫院感染學雜志, 2008, 18(8): 1051-1056.
22. 　李麗, 田磊, 陳中舉, 等. 衛生部全國細菌耐藥監測網2010年中南地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 940-947.
23. 　徐修禮, 周珊.衛生部全國細菌耐藥監測網2010年西北地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 925-931.
24. 　張智潔, 王軍. 衛生部全國細菌耐藥監測網2010年東北地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 948-975.
25. 　馬序竹, 鄭波.衛生部全國細菌耐藥監測網2010年北京地區細菌耐藥性監測[J]. 中國臨床藥理學雜志, 2011, 27(12): 919-924.
26. 　肖書念, 卓超, 鐘南山. 衛生部全國細菌耐藥監測網2010年廣東地區細菌耐藥性監測[J].中國臨床藥理學雜志, 2011, 27(12): 965-971.
27. 　張緯博, 孫景勇, 倪語星. 衛生部全國細菌耐藥監測網2010年華東地區細菌耐藥性監測[J].中國臨床藥理學雜志, 2011, 27(12): 959-964.
28. 　楊央, 呂火祥, 胡慶豐, 等. 1456株連續分離的肺炎克雷伯菌臨床分布及耐藥性分析[J].中國衛生檢驗雜志, 2010, 20(9): 2232-2234.
29. 　蔡佳昌. 腸桿菌科細菌對碳青霉烯類抗生素耐藥機制研究[D]. 浙江：浙江大學博士學位論文. 2010.
30. 　Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing β-Lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae[J]. Antimicrob Agents Chemotherapy, 2001, 45(4): 1151-1161.
31. 　Miriagou V, Tzouvelekis LS, Rossiter S, et al. Imipenem resistance in a salmonella clinical strain due to plasmid-mediated class a carbapenemase KPC-2[J]. Antimicrob Agents Chemotherapy, 2003, 47(4): 1297-300.
32. 　Bratu S, Landman D, Alam M, et al. Detection of KPC carbapenem-hydrolyzing enzymes in enterobacterspp. from Brooklyn, New York[J]. Antimicrob Agents Chemother , 2004, 48(12): 4793-4799.
33. 　Woodford N, Tierno PM, Young JrK, et al. Outbreak of klebsiella pneumoniae producing a new carbapenem-hydrolyzing Class A-Lactamase, KPC-3, in a New York Medical Center[J]. Antimicrob Agents Chemother, 2005, 49(2): 776-778.
34. 　Landman D, Babu E, Patel JB, et al. Transmission of carbapenem-resistant pathogens in New York City hospitals: progress and frustrationm[J]. Antimicrob Chemother, 2012, 67(6): 1427-1431.
35. 　Landman D, Bratu S, Kochar S, et al. Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY[J]. J Antimicro Chemother, 2007, 60(1): 78-82.
36. 　Gupta N, Limbago BM, Patel JB, et al. Carbapenem-resistant enterobacteriaceae: epidemiology and prevention[J]. Clin Infect Dis, 2011, 53(1): 60-67.
37. 　Mathers AJ, Cox HL, Kitchel B, et al. Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals intergenus kpc carbapenemase transmission through a promiscuous plasmid[J]. mBio, 2011, 2(6): 204-211 .
38. 　Osano E, Arakawa Y, Wacharotayankun R, et al. Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance[J]. Antimicrob Agents Chemother, 1994, 38(1): 71-78.
39. 　Miriagou V, Tzelepi E, Gianneli D, et al. Escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-β-Lactamase VIM-1[J]. Antimicrob Agents Chemother, 2003, 47(1): 395-397.
40. 　Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India[J]. Antimicrob Agents Chemother, 2009 , 53(12): 5046-54.
41. 　Deshpande LM, Mendes RE, Castanheira M, et al. Dissemination of NDM-1-producing enterobacteriaceae in India [abstract C2-701]. 50th Interscience Conference on Antimicrobial Agents and Chemotherapy[M]. Boston: American Society for Microbiology, 2010.
42. 　Poirel L, Héritier C, Tolün V, et al. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother J, 2004, 48(1) : 15-22 .
43. 　Cre´ met L, Bourigault CL, Lepelletier D, et al. Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora [J]. Antimicrob Chemother, 2012, 67 (4): 1041-1043.
44. 　李俐, 蔣燕群.大腸埃希菌和肺炎克雷伯菌外膜蛋白與耐藥機制的研究進展[J]. 上海交通大學學報·醫學版, 2010, 30(11): 1433-1436.
45. 　Sureda LG, Dome´nech-Sa´nchez A, Barbier M, et al. OmpK26, a novel porin associated with carbapenem resistance in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother, 2011, 55(10) : 4742-4747.
46. 　Neuwirth C, Siébor E, Duez JM, et al. Imipenem resistance in clinical isolates of Proteus mirabilis associated with alterations in penicillin-binding proteins[J]. Antimicrob Agents Chemother, 1995, 36 (2): 335-342.
47. 　Lee K, Lim YS, Yong D, et al. Evaluation of the Hodge test and the imipenem-EDTA double disk synergy test for differentiating metallo-β- lactamase-producing isolates of Pseudomonas spp and Acinetobacter spp[J]. J Clin Microbiol, 2003, 41(10): 4623-4629.
48. 　McGettigan SE, Andreacchio K, Edelstein PH. Specificity of ertapenem susceptibility screening for detection of Klebsiella pneumoniae carbapenemases[J]. J Clin Microbiol, 2009, 47(3): 785-786.
49. 　Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in enterobacteriaceae[J]. J Clin Microbiol, 2007, 45(8): 2723-2725.
50. 　Hindiyeh M, Smollan G, Grossman Z, et al. Rapid detection of blaKPC carbapenemase genes by internally controlled real-time pcr assay using[J]. J Clin Microbiol, 2011, 49(7) : 2480-2484 .

上一篇
腦干膠質瘤的干細胞研究進展
下一篇
附乳腺低分化葉狀腫瘤伴橫紋肌肉瘤一例

《華西醫學》

臨床分離的耐碳青霉烯類腸桿菌科細菌的研究進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《華西醫學》

臨床分離的耐碳青霉烯類腸桿菌科細菌的研究進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料