澳门地区产超广谱β-内酰胺酶大肠埃希菌基因型分析  

Analysis on Molecular Epidemiological Investigation of Nosocomial ESBLs Producing Escherichia coli in Macao

作　　者：林艳芳[1,2] 江振友[1] 陈琛[1] 施珊珊[1] 孙毅凡[1] 吴莎[1] 

机构地区：[1]暨南大学医学院微生物学与免疫学系,广东广州510632 [2]澳门理工学院高等卫生学校

出　　处：《中山大学学报（医学科学版）》2011年第2期274-278,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(83057);国家自然科学基金(30973693)

摘　　要：【目的】了解澳门地区医院感染产超广谱β-内酰胺酶(ESBL)大肠埃希菌的临床分布特点和基因型特征。【方法】收集2007年12月至2008年2月期间从澳门地区两家医院的临床患者中分离到的大肠埃希菌158株,用表型确定试验确定产ESBL大肠埃希菌。应用PCR方法分别扩增产酶菌株的CTX-M-3、CTX-M-9、TEM和SHV等常见的β-内酰胺酶基因,并结合临床分离菌株的分布特点对PCR扩增结果作进一步的分析。【结果】澳门地区临床分离的158株大肠埃希菌中,有54株产ESBL,产酶率为34.2%。PCR扩增结果显示,所有产酶菌株均携带TEM基因;其中有47株(87%)同时携带CTX-M-9、TEM两个基因;没有菌株携带CTX-M-3和SHV基因。产ESBL大肠埃希菌广泛分布于临床各科室,其中普外科占40.7%,内科占27.8%,心脏科占16.7%。标本分布较为集中,尿液占55.6%,分泌物或脓液标本占22.2%,血液和呼吸道标本各占11.1%。【结论】澳门地区医院感染中,产ESBL大肠埃希菌在临床各科室分布广泛,主要分离自尿液、分泌物或脓液标本;所有菌株均携带TEM基因,并有87%的菌株同时携带CTX-M-9基因。[Objective] To understand the distribution and genotype of nosocomial extended spectrum beta lactamases（ESBL） producing Escherichia coli in Macao.To establish the epidemiological data of nosocomial ESBL producing E.coli in Macao.[Methods] A total of 158 ESBL producing Escherichia coli were determined by phennotypic confirmatory test according to NCCLS standards.3 common beta lactamase genes of CTX-M,TEM,and SHV in ESBL producing non-repeated isolates were amplified by PCR.To analyze the data of PCR product and the distribution in hospital.[Results] Of all isolates,100% was respectively found carrying TEM gene.In addition,87% of all strains carrying more than one beta-lactamase gene.ESBL producing isolates were widely distributed over all of the clinical departments.Urine,discharge or pus,blood and sputum were common samples.[Conclusion] The predominant genotype of nosocomial ESBL producing Escherichia coli in Macao was TEM（100%）,87% of all strains carrying CTX-M-9 gene.May be mutation,they carry another CTX-M-9 gene to have burden.It may be the relation of the exposition,ESBLs producing isolates mostly came from urine and discharge or pus,where they were widely prevalent in that hospital.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 基因型 

分 类 号：R516[医药卫生—内科学]