杭州市产超广谱β-内酰胺酶菌株耐药性和基因型分布研究  

The drug resistance strains producing extended-spectrum β-lactamases and the genotype distribution of β-lactamases

作　　者：吴佳丽[1] 顾洪琴[1] 俞云松[2] 周志慧[2] 陈亚岗[2] 李兰娟[2] 

机构地区：[1]杭州市第三人民医院,310009 [2]浙江大学医学院附属第一医院

出　　处：《浙江医学》2005年第6期401-403,共3页Zhejiang Medical Journal

基　　金：杭州市医药卫生科技项目00A023

摘　　要：目的了解杭州市产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的耐药性及ES-BLs基因型分布。方法采用浓度梯度法(Etest)测定分离自杭州市五家医院的51株产ESBLs的大肠埃希菌和肺炎克雷伯菌对12种抗菌药物的最低抑菌浓度(MIC),通过聚合酶链反应(PCR)法及克隆测序分析其所产生的ESBLs基因型。结果51株菌株对亚胺培南全部敏感,对头孢哌酮/舒巴坦、头孢他啶和哌拉西林/三唑巴坦的敏感率为60.00%～80.00%,而对其它抗菌药物敏感率较低,对头孢噻肟的敏感率仅为5.88%。51株菌株有47株产CTX-M型ESBLs,其中CTX-M-14最多见,其次为CTX-M-3、CTX-M-24、CTX-M-22。结论杭州市产ES-BLs大肠埃希菌和肺炎克雷伯菌耐药性严重,ESBLs基因型以CTX-M型为主。Objective To investigate the drug resistance of Escherichia coli and Klebsiella pneumonia producing extended spectrum β-lactamases (ESBLs) and the genotype of ESBLs in Hangzhou. Methods MICs to 12 antibiotics of 51 strains of Escherichia coli and Klebsiella pneumonia producing ESBLs were detected by E test. All strains were collected in five hospitals of Hangzhou city. The genotypes of ESBLs were detected by PCR, sequencing and isoelectric focusing. Results The sensitive rates of 51 strains to Imipenem were 100.0%, and to Cefoperazone/ Sulbactam, Ceftazidime and Piperacillin/Tazobactam were 60.0%～80.0%. The sensitive rates to other antimicrobial agents were lower, for example that to Cefotaxime was only 5.9%. 47 strains produced CTX-M type ESBLs, most of that were CTX-M-14, others were CTX-M-3, CTX-M-24 and CTX-M-22. Conclusion The resistance of Escherichia coli and Klebsiella pneumonia producing ESBLs in Hangzhou were severe and CTX-M type ESBLs were the most common genotype.

关 键 词：杭州市 超广谱Β-内酰胺酶 菌株 耐药性 基因型 ESBLS 肺炎克雷伯菌 大肠埃希菌 

分 类 号：R446.5[医药卫生—诊断学]