大肠杆菌耐药现状与耐药质粒分析  

Analysis of antibiotic resistance and resistant plasmids of E.coli

作　　者：黄加权[1] 高美英[1] 

机构地区：[1]同济医科大学附属同济医院

出　　处：《中华传染病杂志》1996年第2期70-73,共4页Chinese Journal of Infectious Diseases

摘　　要：为了解医院内感染大肠杆菌的耐药状况，初步探讨其耐药发生机制。对１９９２年１月～１９９３年１０月我院临床分离５７株院内感染大肠杆菌进行了药敏试验、质粒图谱分析及β－内酰胺酶测定。结果仅５．３％菌株对全部抗菌剂敏感，７０．２％的菌株对３种和３种以上的抗菌剂耐药，８９．４％的菌株检出分子量为０．９～６０ｋｂ的２１个ＣＣＣ型质粒，共具２３个质粒谱型。６０ｋｂ、５．５１ｋｂ、１３．６０ｋｂ、２．０３ｋｂ质粒在我院分离的大肠杆菌中出现频繁，产β－内酰胺酶的阳性率为５２．６％，产酶阳性株９６．１％含质粒。提示我院分离的大肠杆菌耐药情况严重，质粒介导耐药可能是大肠杆菌耐药性发生的重要机制，大肠杆菌所产β－内酰胺酶绝大部分由质粒介导，应用β－内酰胺酶抑制剂有其理论基础。To investigate E.coli from the aspects of drug resistance and its mechanism,westudied 57 strains of E. coli isolated from January 1992 to October 1993 in our hospital.This studyincluded drug susceptibility,plasmid profile,and the detection ofβ-lactamase.Only 5.26%ofstrains were sensitive to all antibiotics tested, with 70.2%resistant to three or more kinds of antibi-otics.Plasmids were detected in 89.4%of the strains.there were 21 types of CCC plasmids,rang-ing from 0.9 to 60kb,forming 23 patterns.60kb,5.51kb,3.6kb and 2.03kb plasmids were moreprevalent in our hospital.β-lactamase were positive in high rates and reached 52.6%. 96.1%ofβ-lactamase-producing strains carrying plasmids.This suggested that most E. coli strains were resis-tant to various antibiotics.The plasmid-mediated drug resistance might be the resistance mechanismof E. coli,and the production ofβ-lactamase was mainly mediated by plasmids.It could be the theo-retical basis of chosingβ-Iactamase inhibitors clinically.

关 键 词：大肠杆菌 耐药质粒 Β-内酰胺酶 

分 类 号：R378.21[医药卫生—病原生物学]