沈阳地区儿科产超广谱β-内酰胺酶革兰阴性菌的耐药性与基因型研究  

Investigation of antimicrobial resistance and genotypes of extended-spectrum β-lactamases-producing Gram-negative bacteria isolated from pediatrics in Shenyang

作　　者：倪朝辉[1] 李凡[1] 

机构地区：[1]吉林大学基础医学院病原生物教研室,长春130021

出　　处：《中国抗生素杂志》2006年第11期692-696,共5页Chinese Journal of Antibiotics

基　　金：国家"十五"科技攻关项目(项目编号:2004BA720A09-02)

摘　　要：目的研究沈阳地区儿科产超广谱β-内酰胺酶(ex tended-spectrum-βlactam ases,ESBL s)革兰阴性菌的耐药性及ESBL s基因型分布,初步探讨其多重耐药性传播的分子机制。方法KB法药敏试验,按照CLS I/NCCLS 2005年标准筛选确认ESBL s表型,PCR法进行ESBL s基因型别分析,扩增I类整合子全可变区,分析产ESBL s菌株中整合子的存在情况。结果在分离出的180株革兰阴性菌中,有62株经表型确证试验证实为产ESBL s菌株,检出率34.4%。产ESBL s菌株对各种抗菌药物的耐药率明显高于非产ESBL s菌株。基因分型结果表明,blaTEM基因阳性48株(77.4%),blaSHV阳性32株(51.6%),blaCTX-M 9组阳性31株(50%),blaCTX-M 3组阳性12株(19.4%)。62株ESBL s菌株中26株整合子全可变区PCR扩增阳性,阳性率41.9%。结论沈阳地区儿科革兰阴性菌中ESBL s菌株检出率较高,多数菌株同时携带两种或两种以上不同型别的β-内酰胺酶,且为多重耐药菌株,整合子机制参与其多重耐药性的形成与传播。Objective To study the antimicrobial resistance and genotypes of extended-spectrum β-lactamases （ESBLs）-producing Gram-negative bacteria isolated from pediatrics in Shenyang and preliminarily investigate the molecular mechanisms of their muhiple antibiotic resistance dissemination process. Methods Antibiotics susceptibility was tested by Kirby-Bauer method. ESBLs-producing isolates were detected by phenotypic confirmatory test according to CLSI/NCCLS M100-S15 （2005）. The genotypes of ESBLs were analyzed by PCR, and the complete variable region of class 1 integron were amplified in order to analyze the presence and characterization of class 1 integron in ESBLs. Results Among a total of 180 Gram-negative isolates, 62 isolates were identified as ESBLs by phenotypic confirmatory test and the incidence was 34.4%. The ESBLs- producing isolates were more resistant to most antimicrobials than non- ESBLs-producers. The results of β- lactamases genotyping showed that 48 isolates carried blaTEM（77. 4%）, 32 isolates carried blasHv（51.6%）, 31 isolates carried blaCTX-M9 （50%）and 12 isolates carriecl blaCTX-M-3 （19.4%）. Class 1 integrons were identified among 26 isolates and the positive rate was 41.9%. Conclusions In Shenyang pediatrics, the incidence of ESBLs-producing strains was high and most isolates were multiple resistant and produced more than one type of β-lactamase. The mechanisms of integron took part in the emergence and dissemination of their multiple resistance.

关 键 词：革兰阴性菌 超广谱Β-内酰胺酶 耐药 基因型 整合子 沈阳地区 儿科 

分 类 号：R378[医药卫生—病原生物学]