老年患者中检出产ESBLs大肠埃希菌的耐药性和基因分型  

Drug Resistance and Genotyping of ESBL-producing Escherichia coli Detected from the Elderly Patients

作　　者：关学芳[1] 孙圣明[2] 

机构地区：[1]湖南省常德市疾病预防控制中心,湖南常德415000 [2]常德职业技术学院附属一医院

出　　处：《实用预防医学》2011年第5期927-928,共2页Practical Preventive Medicine

摘　　要：目的了解本地区老年患者临床分离的产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的耐药基因型别和耐药性的变化情况。方法收集来自老年患者分离鉴定的大肠埃希菌株1 327株,通过K-B法作药敏试验,采用美国NC-CLS1999年推荐的抑制剂增强纸片法确认产ESBLs株,并对ESBLs进行初步基因分型。结果检出产ESBLs菌株702株,检出率为52.9%,产ESBLs大肠埃希菌对青霉素类、氨曲南及头孢菌素类抗生素耐药率为54.5%~100.0%;PCR初步分型结果：单独携带TEM型基因的占56.7%,单独携带SHV型基因的占15.0%,携带两种基因的占25.8%。结论产ESBLs大肠埃希菌检出率逐年上升,具有多重耐药的特点;产ESBLs大肠埃希菌主要携带TEM型和SHV型β-内酰胺酶基因,其中绝大部分为产TEM型β-内酰胺酶。Objective To investigate the drug resistance changes and genotypes of ESBL（extended-spectrum beta-lactamase） producing Escherichia coli isolated from the elderly patients in Changde. Methods Totally 1,327 ESBL-producing Escherichia coli strains isolated from the clinical samples of the elderly patients were collected.The drug sensitivity testing was performed by the K-B method.ESBL-producing Escherichia coli strains were identified by inhibitor-potentiated disc-diffusion test recommended by the American National Committee for Clinical and Laboratory Standards（NCCLS,1999）, and then ESBLs genotypes were determined preliminarily. Results A total of 702 ESBL-producing strains were detected,with the detection rate of 52.9%.The drug resistant rates of ESBL-producing Escherichia coli strains against penicillin,aztreonam and cephalosporin antibiotics were between 54.5% and 100.0%.The results of preliminary classification by PCR showed that the rates of TEM type,SHV type,and TEM with SHV type were 56.7%,15.0%,and 25.8%,respectively. Conclusions The detection rate of ESBL-producing Escherichia coli is gradually increasing,and it shows the characteristic of multi-drug resistance.Most of the ESBL-producing Escherichia coli carry TEM related genes or SHV related genes,and most carry TEM related genes.

关 键 词：超广谱β-内酰胺酶(ESBLs) 大肠埃希菌 耐药性 基因分型 

分 类 号：R37[医药卫生—病原生物学]