合肥市产超广谱β-内酰胺酶菌株的SHV型耐药基因分布和耐药性分析  

Distribution of SHV genotypes and resistance analysis of extended-spectrum β-lactamases-producing klebsiella pneumoniae and escherichia coli isolates in Hefei

作　　者：程君[1] 王迎迎[1] 李慧[1] 李家斌[1,2] 

机构地区：[1]安徽医科大学第一附属医院感染病科,安徽合肥230022 [2]安徽省细菌耐药性监控中心,安徽合肥230022

出　　处：《中国药理学通报》2007年第6期812-815,共4页Chinese Pharmacological Bulletin

基　　金：国家自然科学基金资助项目(No30571654)

摘　　要：目的了解1999～2000年合肥市临床分离的产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌中,SHV型β-内酰胺酶基因型分布情况和耐药性分析。方法标本为安徽省细菌耐药性监控中心所留取的1999年9月～2000年9月从合肥市4家大医院临床分离的、已被证实产ESBLs的98株肺炎克雷伯菌和大肠埃希菌,采用聚合酶链反应(PCR)扩增产SHV型β-内酰胺酶菌株基因片段,克隆入pGEM-Teasy载体,双脱氧链终止法测定核苷酸序列以鉴定基因型。按照2005年CLSI推荐标准,用琼脂稀释法分别测定临床分离菌株和转移结合子对11种不同抗菌药物的MIC值,并比较分析两者的不同结果。结果98株产ESBLs菌株中有29株产SHV型β-内酰胺酶,其中SHV-1型8株,SHV-11型5株,SHV-12型11株,SHV-18型1株,SHV-28型1株,SHV-89型3株[序列号为(DQ193536)]。临床分离株的MIC结果显示对哌拉西林,头孢噻肟,头孢曲松的敏感率低;转移结合子的敏感性较临床分离菌株有所上升。结论合肥市部分医院产SHV型β-内酰胺酶肺炎克雷伯菌和大肠埃希菌检出率较高,我们在国内外首次报道了SHV-89;并且本地区产SHV型β-内酰胺酶菌株的耐药性较高。Aim To study the SHV genotype and analyze resistance of extended-spectrum β-lactamases （ ESBLs ）-producing Klebsiella pneumoniae （ Kpn ） and Escherichia coli （Eco） strains isolated from clinical patients in Hefei during 1999 - 2000. Methods Ninety-eight strains of Klebsiella pneumoniae and Escherichia coli conserved by Anhui center for surveillance of bacterial resistance were collected from four general hospitals, including First affiliated hospital of Anhui medical university, Anhui province hospital, first people＇s hospital of Hefei and the 105th hospital of PLA, from September 1999 to September 2000. The encoding genes of SHV β-1actamases produced by ESBLs-producing isolates were amplified by PCR. The purified PCR products were cloned into pGEM-Teasy vectors and sequenced by sanger＇s dideoxy chain termination composition method recommended by CLSI. Their resistances to 11 antimicrobial agents were tested by agar dilution. MICs of the antimicrobial agents against clinical isolates and the transconjugants were determined. Results Twenty-nine out of ninety-eight ESBLs-producing isolates produced SHV β-1actamases. Of twenty-nine isolates producing SHV β-1actamases, eight strains produced SHV-1, five strains produced SHV-11, eleven strains produced SHV-12, one strain produced SHV-18, one strain produced SHV-28, and three produced a novel SHV type SHV-89 （Accession No. DQ193536）. All the strains had the same susceptible pattern, with the low susceptibility rate to piperacillin, ceftriaxone and cefotaxime. All the strains were susceptible to imipenem. Compared with clinical strains, the transconjugants showed higher resistance to many antimicrobial agents. Conclusions The rates of SHV β-lactamases-producing klebstella, pneumoniae and Escherichia coli reach a high level in hospitals in Hefei. This is the first report on SHV-89 in China. The high resistance may be present in these clinical isolates in Hefei area.

关 键 词：超广谱Β-内酰胺酶 SHV型β-内酰胺酶 聚合酶链反应 序列分析 基因型 耐药性 

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