临床产ESBLs大肠埃希菌耐药表型及基因型的研究  

Study on resistant phenotype and genotype of ESBLs-producing Escherichia coli in clinical isolates

作　　者：韩珍[1] 李向阳[2] 杨锦红[2] 李方去[2] 方晔[1] 

机构地区：[1]温州医学院,浙江温州325000 [2]温州医学院附属第二医院检验科,浙江温州325000

出　　处：《检验医学》2008年第4期397-400,共4页Laboratory Medicine

摘　　要：目的了解温州医学院附属第二医院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的耐药情况及该70株细菌的常见β-内酰胺酶的基因型别。方法采用Kirby-Bauer(K-B)琼脂扩散法检测70株临床分离的产ESBLs大肠埃希菌对14种抗生素的耐药性,聚合酶链反应(PCR)检测其常见β-内酰胺酶的基因型别。结果70株产ES-BLs的大肠埃希菌对14种抗生素的敏感性排在前3位的是亚胺培南(100.0%)、头孢哌酮-舒巴坦(100.0%)及哌拉西林-他唑巴坦(94.1%);PCR电泳结果显示62株(88.6%)出现TEM阳性条带,5株(7.1%)出现SHV阳性条带,1株(1.4%)出现OXA阳性条带,61株(87.1%)出现CTX-M阳性条带,未见VEB及PER阳性条带。结论该70株产ESBLs大肠埃希菌对临床常用抗生素均有较高的耐药率,治疗其感染的首选药物为亚胺培南和头孢哌酮-舒巴坦,其次为哌拉西林-他唑巴坦,其耐药基因以TEM型、CTX-M型为主。Abstract： Objective To investigate the antibiotic-resistance and the genotype of common β-lactamases of 70 extended spectrum β-lactamase （ESBLs）-producing strains of Escherichia coli in the second hospital affiliated to Wenzhou medical college. Methods Antibiotic susceptibilities of 70 ESBLs-producing strains of Escherichia coli were determined by Kirby-Bauer（K-B） test, the gene type of common β-lactamases was confirmed by polymerase chain reaction （PCR）. Results The first three susceptible antimicrobial drugs for the 70 ESBLs-producing strains of Escherichia coli were imipenem （100.0%） , cefoperazone-sulbactam （100.0%） and piperacillin-tazobactam （94.1%） ; The polyacrylamide gel electrophoresis of their PCR products revealed that 62 （88.6%） strains harbored TEM type, 5 （7. 1% ） strains SHV type, 1 （1.4%）strain OXA type,61 （87.1% ） strains CTX-M type, none was for VEB and PER. Conclusions The resistant rate to most antibiotic of the 70 ESBLs-producing strains of Escherichia coli is rather high. Imipenem and cefoperazone-sulbactam are the best drug for treatment of the infection, the next is piperacillin-tazobactam; They mainly carry TEM and CTX-M resistant gene.

关 键 词：超广谱Β-内酰胺酶 大肠埃希菌 耐药性 基因型 

分 类 号：Q556[生物学—生物化学]