耐三代头孢菌素阴沟肠杆菌临床株中CTX-M型ESBLs与Ⅰ类整合子的相关性  

Investigation of the relationship between CTX-M-ESBLs and class Ⅰ integron in enterobacter cloacae clinical strains resistant to third generation cephalosporins

作　　者：程玉谦[1] 宋诗铎[1] 郭庆兰[1] 祁伟[1] 

机构地区：[1]天津医科大学第二医院天津市感染性疾病研究所,300211

出　　处：《中华传染病杂志》2005年第5期305-309,共5页Chinese Journal of Infectious Diseases

基　　金：天津市科技发展计划资助项目(003113511)

摘　　要：目的研究CTX-M型超广谱β内酰胺酶(ESBLs)及Ⅰ类整合子在耐三代头孢菌素阴沟肠杆菌中的分布,进一步探讨Ⅰ类整合子与CTX-M型ESBLs的关系。方法运用K-B法检测阴沟肠杆菌临床株的耐药表型,双纸片协同试验(DDST)初筛产ESBLs的菌株,聚合酶链反应(PCR)扩增确证产CTX-M型ESBLs和含有Ⅰ类整合子的临床菌株,套式PCR及序列测定寻找携带CTX-M型ESBLs基因盒的Ⅰ类整合子。结果37株耐药菌中,21株菌产生CTX-M型ESBLs;20株菌含有Ⅰ类整合子;在13株同时产生Ⅰ类整合子和CTX-M型ESBLs的临床株中,3株菌CH4、CH11和Q1的CTX-M型ESBLs基因盒分布在Ⅰ类整合子上。结论Ⅰ类整合子的存在增加了ESBLs在临床株中水平播散的危险,是造成多重耐药株在院内暴发流行的重要原因。Objective To study the distribution of CTX-M-ESBLs and class Ⅰ integron in enterobacter cloacae resistant to third generation cephalosporins, and discuss the relationship between CTX-M-ESBLs and class Ⅰ integron. Methods K-B test for resistances DDST and PCR for CTX-M-ESBLs; PCR, nested-PCR and sequence analysis for finding class Ⅰ integron carrying CTX-M-ESBLs gene cassette. Results Among 37 strains, there are 21 isolates producing CTX-M-ESBLs, 20 isolates with class Ⅰ integron and 13 isolates carrying CTX-M-ESBLs as well as class Ⅰ integron. In 3 isolates： CH4, CH11 and Q1, each class Ⅰ integron haboured CTX-M-ESBLs gene cassette. Conclusions There is few report on class Ⅰ integron carrying CTX-M-ESBLs, which caused more dangers of horizontal transmission of ESBLs and was important factor to nosocomial outbreak of multiresistant clinical isolates.

关 键 词：肠杆菌 阴沟 Β内酰胺酶类 整合子类 

分 类 号：R378[医药卫生—病原生物学]