广州地区大肠埃希菌与肺炎克雷伯菌CTX-M型产超广谱β-内酰胺酶基因分型的研究  

Antibiotic Resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae Isolates with CTX-M Genotypes in Guangzhou:Analysis of Their Genotyping

作　　者：苏丹虹[1] 卢鉴财[1] 卓超[2] 李红玉[3] 陈冬梅[4] 王媚[5] 郑君德[1] 钟南山[2] 

机构地区：[1]广州医学院第一附属医院检验科,广东广州510120 [2]广州呼吸疾病研究所呼吸内科,广东广州510120 [3]中山大学附属第二医院检验科,广东广州510120 [4]中山大学附属第一医院检验科,广东广州810080 [5]广东省人民医院检验科,广东广州510080

出　　处：《中华医院感染学杂志》2009年第22期3004-3006,共3页Chinese Journal of Nosocomiology

基　　金：广州市科技局重点攻关项目(2006Z1-E0141)

摘　　要：目的对肺炎克雷伯菌和大肠埃希菌(ECO)CTX-M型产超广谱β-内酰胺酶(ESBLs)菌株进行耐药基因分型,从而调查广州地区目前临床分离菌对抗菌药物的耐药性。方法收集广州地区9所医院临床分离所获产ESBLs肺炎克雷伯菌(KPN)和ECO CTX-M型菌株,应用纸片扩散筛选法和纸片扩散确证法对菌株进行确认,然后用PCR方法对ESBLs进行基因分型。结果92株产ESBLs ECO,对氨苄西林、哌拉西林和头孢呋辛均高度耐药,耐药率分别为97.5%、89.5%和89.5%;42株产ESBLs KPN对氨苄西林(100.0%)和哌拉西林(100.0%)也呈高度耐药;PCR及测序结果显示,CTX-M-1群阳性株包括ECO 7株、KPN 9株,阳性率分别为7.6%和21.4%,基因型分布在ECO为CTX-M-3、CTX-M-15和CTX-M-55型,而在KPN为CTX-M-3和CTX-M-15型。结论广州地区9所医院临床分离的134株产ESBLs大肠埃希菌和肺炎克雷伯菌,对青霉素类和头孢菌素类抗菌药物的耐药率均达到很高水平,并且在广州地区首次分离获得CTX-M-55型耐药菌株。OBJECTIVE To type the antibiotic resistance of ESBLs producing Klebsiella pneumoniae （KPN） and Escherichia coli （ECO） with CTX-M genotypes, and to investigate the present situation of antibiotic resistance of the said bacteria clinically isolated in Guangzhou. METHODS Clinical isolatates of ESBLs producing ECO and KPN were collected from 9 hospitals in Guangzhou. Disk diffusion method was used for further confirmation. And then geneotyping analysis was performed with PCR and sequeneing. RESULTS The resistance rates of the 92 ESBLs- producing ECO to ampicillin, cefuroxime sodium and piperaeillin were 97.5%, 89.5% and 89.5% respectively. And all of the 42 ESBLs-producing KPN isolates were resistant to ampicillin and piperacilin （100%）. Genotype distribution showed esistenee of CTX-M-3, CTX-M-15 and CTX-M-55. Of all the ESBLs producing strains, seven ECO （7.6 %） and nine KPN strains （21.4 % ） were CTX-M-1-positive. CONCLUSIONS The resistances of the 134 ESBLs-producing ECO and KPN strains isolated from nine hospitals in Guangzhou to penicillin and cephalosporins are very high. CTX-M-55 is the first time found in Guangzhou.

关 键 词：肺炎克雷伯菌 大肠埃希菌 耐药性 CTX-M型 

分 类 号：R378[医药卫生—病原生物学]