产超广谱β-内酰胺酶细菌耐药性基因型分析  

Genotype Analysis of Drug Resistance of Super-Broad-Spectrum β-Lactamases Producing Bacteria

作　　者：张晓丽[1] 张吉生[1] 斗章[1] 张敬凯[2] 王宇超[1] 付成显[1] 

机构地区：[1]佳木斯大学临床医学院检验系,黑龙江佳木斯154002 [2]鸡西矿业集团总医院检验科,黑龙江鸡西158100

出　　处：《微生物学杂志》2010年第1期51-55,共5页Journal of Microbiology

基　　金：黑龙江省卫生厅项目(2009-325);佳木斯大学科技研究项目(S2009-055)

摘　　要：检测我院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的耐药性和基因型。表型确定临床分离产ESBLs的大肠埃希菌和肺炎克雷伯菌56株,应用PCR基因扩增技术及双脱氧DNA测序方法,分别对TEM、SHV、CTX-M-1、CTX-M-2和CTX-M-9编码基因进行分析。产酶菌株对亚胺培南、美洛培南、阿米卡星、头孢吡肟耐药性较低,对其他16种抗生素耐药性较高。在56株菌株中有50株为CTX-M型,占89%,34株为TEM型(60.7%),20株SHV型(35.7%);其中CTX-M-9型共计39株占78%,CTX-M-1型19株占38%,CTX-M-2型16株占32%。产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性值得关注,主要临床流行基因型是CTX-M型。Drug resistance and genotypes of super-broad-spectrum β-lactamases （ESBLs） producing E.coli and Klebsiella pneumoniae （Ec Kp） were tested in the hospital.59 strains of Ec Kp expressing confirmed clinically to be SBSLs were collected and analyzed for their encoding genes of TEM,SHV,CTX-M-1,CTX-M-2,and CTX-M-9 with PCR and double deoxy-DNA sequencing method separately.The results showed that the enzyme-producing strains were more sensitive to Imipenem,Meropenem,Amikacin and Cefepime but highly resistant to 16 other antibiotics.Among the 56 strains there were 50 strains to be CTX-M type,account for 89%,34 strains to be TEM type （60.7%）,20 strains SHV type （35.7%）,39 strains CTX-M-9 type （78%）,19 strains CTX-M-1 type （38%）,16 strains CTX-M-2 type （32%）.It is worthy to pay close attention to the ESBLs producing Ec Kp especially to that prevalent clinical genotype of CTX-M.

关 键 词：大肠埃希菌 肺炎克雷伯菌 超广谱Β-内酰胺酶 基因型 

分 类 号：R446.5[医药卫生—诊断学]