产ACT-2型头孢菌素酶和CTX-M型超广谱β-内酰胺酶及携带Ⅰ类整合子的大肠埃希菌  

Clinical isolate of Escherichia coli producing ACT-2 type cephalosporinase accompanied with CTX-M β-lactamases and classⅠintegron

作　　者：叶英[1] 高建国[1] 李家斌[1] 

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥市230022

出　　处：《中华实验和临床感染病杂志（电子版）》2008年第4期264-270,共7页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金项目(30772286);安徽省自然科学基金项目(070413110)

摘　　要：目的分析大肠埃希菌临床分离菌(E1)携带的β-内酰胺酶基因(AmpC,ESBLs)及Ⅰ类整合子基因的存在情况。方法应用琼脂稀释法测定E1菌的耐药表型,应用聚合酶链反应及序列分析法分析其AmpC,ESBLs和整合子的基因类型,并进行质粒接合转移实验。结果E1仅对亚胺培南、环丙沙星、左旋氧氟沙星和阿米卡星敏感,同时携带CTX-M-13、SHV-1、TEM-1和ACT-2型β-内酰胺酶基因,Ⅰ类整合子基因呈阳性。结论大肠埃希菌耐药机制复杂,可同时携带多种β-内酰胺酶,并已成功地将AmpC和ESBL接合在一起,对此类产酶菌应首选碳青酶烯类药物进行治疗,并应高度重视整合子对多重耐药形成的作用。Objective To detect the genes of plasmid-mediated AmpC and ESBL β-lactamases and ClassⅠintegron in clinical isolate of Escherichia coli.Methods The bacterial susceptibility to antimicrobial agents for strain E1 was determined by agar dilution method.The genes of AmpC,ESBLs and integron were analyzed by PCR and verified by DNA sequencing.Conjugation experiment was carried out to study the transfer of drug resistance.Results The strain was susceptible to imipenem,ciprofloxacin,levofloxacin and amikacin.ACT-2,SHV-1,TEM-1,CTX-M-13 and interon Ⅰgenes were positive.Conclusions It has complicated mechanism of drug resistance.Some of clinical strains producing plasmid-mediated AmpC β-lactamase were accompanied by extensively producing ESBLs.Carbapenems is the best choice for treatment infection caused by strains producing ESACs.More attention should be paid to integron which plays an important role in multi-resistance.

关 键 词：大肠埃希菌 Β-内酰胺酶 基因 整合子 耐药性 

分 类 号：R450[医药卫生—治疗学]