2277株大肠埃希菌的耐药性及TEM与SHV型β-内酰胺酶基因的研究  

Drug Resistance of 2277 Strains of Escherichia coli and Detection of TEM and SHV Type β-Lactams Gene

作　　者：俞莲花[1] 潘春琴[1] 胡大康[1] 刘池波[1] 王冬国[1] 

机构地区：[1]台州市立医院检验科,浙江台州318000

出　　处：《中华医院感染学杂志》2009年第11期1332-1334,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解大肠埃希菌的耐药性,尤其要了解TEM与SHVβ-内酰胺酶基因在产ESBLs大肠埃希菌的流行情况。方法2006年1月-2008年11月医院分离的2277株大肠埃希菌用VITEK-32 GNI+鉴定,GNS-145和GNS-448检测对氨基糖苷类、β-内酰氨类、喹诺酮类等21种抗菌药物的耐药性,并对其中36株产ESBLs大肠埃希菌用聚合酶连反应(PCR)检测TEM和SHV基因型别的流行状况。结果共检出1025株ESBLs阳性菌株,ESBLs检出率为45.0%;21种抗菌药物氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢呋辛、氨曲南、头孢匹肟、头孢他啶、头孢曲松、头孢噻肟、环丙沙星、左氧氟沙星、庆大霉素、阿米卡星、妥布霉素、复方新诺明、呋喃妥因、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和头孢西丁耐药率分别为83.0%、74.0%、52.0%、52.0%、29.1%、27.8%、16.5%、47.0%、31.0%、54.5%、53.0%、56.8%、10.0%、53.9%、38.5%、5.0%、4.0%、5.0%和5.0%,未检出亚胺培南、美罗培南耐药株;36株产ESBLs大肠埃希菌PCR检测结果TEM阳性25株,SHV阳性14株,检出率分别为69.4%和38.9%。结论大肠埃希菌耐药性严重,尤其是产ESBLs大肠埃希菌存在着严重的多药耐药性,产ESBLs大肠埃希菌菌株TEM和SHV基因检出率高,且与多药耐药关系密切。OBJECTIVE To investigate drug resistance of Escherichia coli, especially the prevalence of the genes for TEM and SHV type β-laetams in ESBLs-producing E. coli. METHODS A total of 2277 strains of E. coli collected in our hospital from Jan 2006 to Nov 2008 were analyzed for drug resistance to 21 kinds of antibioties such as aminoglycoside, β-lactams and quinolones using VITEK-32 GNS- 145 or GNS- 448 card following GNI＋ for identification. PCR methods were used to analyze TEM and SHV type β-laetams genes in 36 strains of E. coli with ESBLs so as to study their prevalence. RESULTS From them 1025 strains of E. coli were found positive for ESBLs, with a positive rate of 45.0%. Drug resistance rates were 83.0%, 74.0%, 52.0%, 52.0%, 29. 1%, 27.8%, 16.5%, 47.0%, 31.0%, 54.5%, 53.0%, 56.8%, 10.0%, 53.9%, 38.5%, 5.0%, 4.0%0, 5.0% and 5. 0%, respectively, for ampicillin, ampicillin/sulbactam, cefazolin, cefuroxime, aztreonam, cefepime, ceftazidime, ceftriaxone, cefotaxime, ciprofloxacin, levofloxaein, gentamicin, amikacin, tobramycin, Cotrimoxazole, nitrofurantoin, piperacillin/tazobactam, cefoperazone/sulbactam and cefoxitin. None was found resistant to imipenem or meropenem. Twenty-five and 14 strains of E. coli were found positive for TEM and SHV genes, respectively（69.4% and 38.9%）. CONCLUSIONS Drug resistance of E. coli is severe. The local E. coli with ESBLs shows high positive rates of TEM and SHV genes, which play an important role in its severe drug resistance.

关 键 词：大肠埃希菌 耐药性 超广谱Β-内酰胺酶 Β-内酰胺酶基因 

分 类 号：R378.21[医药卫生—病原生物学]