产超广谱β-内酰胺酶大肠杆菌耐药性及基因型检测  

Detection of drug resistance and genotype of extended-spectrum β-lactamases producing Escherichia coli

作　　者：程训民[1] 李敏[1] 徐元宏[2] 张琪[1] 朱素珍[1] 

机构地区：[1]淮北市人民医院检验科,淮北235000 [2]安徽医科大学第一附属医院检验科,合肥230022

出　　处：《第三军医大学学报》2006年第16期1685-1687,共3页Journal of Third Military Medical University

基　　金：安徽省卫生厅自然科研基金资助项目(2002A012);淮北市科技局科研基金资助项目(030131)~~

摘　　要：目的探讨产超广谱β-内酰胺酶(extended-spectrumβ-lactamases,ESBLs)大肠埃希菌的分子流行病学及对常用抗菌药物的耐药情况。方法产超广谱β-内酰胺酶大肠埃希菌的初筛试验采用纸片法,并用确证试验加以确认;用PCR的方法扩增其ESBLs基因片段;用K-B琼脂扩散法进行菌株的药敏试验。结果124株大肠埃希菌中共检出54株产ESBLs(43.5%)。在耐药性检测中,其对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南的耐药率分别为3.7%、0.0%和5.6%,PCR扩增基因型阳性结果为TEM型23株、SHV型13株、CTX-M型41株、OXA型8株,其基因型以CTX-M型为主。结论本院大肠埃希菌产ESBLs率显著升高,应引起重视;基因型以CTX-M型为主,有些菌株同时携带两种或两种以上耐药基因;其治疗首选药物建议使用亚胺培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦。Objective To explore the molecular epidemiology and antimicrobial resistance of extendedspectrum β-lactamases （ESBLs） producing Escherichia coll. Methods The strains of ESBLs-producing Escherichia coli were identified by disk diffusion method and confirmatory test. The ESBLs encoding genes were amplified by PCR. The antibiotic susceptibility of clinical isolates were tested by Kirby-Bauer method. Results In 124 clinical isolates of Escherichia coli analyzed, 54 ESBLs-producing isolates were detected （43.5%）. The resistance rates of Escherichia coli to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem were 3.7%, 0.0% and 5.6% respectively. In 54 ESBLs-producing strains, TEM-type, SHV-type, CTX-M-type , OXA-type accounted for 23, 13, 41, 8 respectively, and ESBLs encoding gene mainly belonged to CTX-M-type. Conclusion The fact that the occurrence of ESBLs-producing Escherichia coli increased significantly in the region should be paid more attention to. The major ESBLs encoding gene is CTX-M-type, and some strains carrying two or more than two types of drug resistance genes. Piperacillin/tazobactam, cefoperazone/sulbactam, imipenem are suitable in managing the infection caused by ESBLs-producing Escherichia coli strains.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 基因型 耐药性 

分 类 号：R378.21[医药卫生—病原生物学] R394.2[医药卫生—基础医学]