产CTX-M酶肠杆菌科细菌耐药性及其相关耐药基因研究  

Research on resistance of enterobacteriaceae bacteria producing CTX-M enzymes and correlated resistant genes

作　　者：姚杰[1,2] 徐元宏[1] 贾建安[3] 陶勇[3] 

机构地区：[1]安徽医科大学第一附属医院检验科,安徽合肥230032 [2]安徽医科大学第二附属医院检验科,安徽合肥230601 [3]解放军第105医院检验科,安徽合肥230031

出　　处：《中华医院感染学杂志》2011年第14期2874-2877,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解产CTX-M型超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌的阳性率、耐药性以及基因型分布。方法采用纸片扩散法检测临床分离大肠埃希菌和肺炎克雷伯菌对18种抗菌药物的耐药性,用聚合酶链反应(PCR)技术检测相关耐药基因并用DNA序列分析确认基因亚型。结果检测菌株中ESBLs阳性56株,阳性率为44.4%;检测菌株对亚胺培南全部敏感,质粒接合试验证实,CTX-M型ESBLs介导的耐药可以水平转移;产ESBLs阳性菌株中有48株扩增到CTX-M型耐药基因,其中CTX-M-3型11株,CTX-M-9型7株,CTX-M-14型25株。结论产CTX-M型ESBLs大肠埃希菌和肺炎克雷伯菌检出率较高,以CTX-M-14型为多;碳青霉烯类抗菌药物是目前治疗产ESBLs细菌最有效药物。OBJECTIVE To investigate the positive rate, drug resistance and genotype distribution of Enterobacteriaceae bacteria producing CTX-M-type extended-Spectrum β-1actamases （ESBLs）. METHODS The resistence of Escherichia coli and Klebsiella pneumoniae to 18 kinds of antibiotics were assayed with K-B agar diffusion, using PCR method to detect the relevant resistance gene, and using DNA sequence analysis confirmed gene subtypes. RESULTS There were 56 of 76 stains E. coli and K. pneumoniae had ESBLs positive phenotype, the positive rate was 44.4%. All detected strains were imipenem-sensitive. Ptasmid bonding test confirmed that CTX-M type ESBLs-mediated resistance is transferable, phenotype-positive strains have amplified 48 to CTX-M-type resistance genes, 11 strains were CTX-M-3 type,7 strains were CTX-M-9 type and 25 strains were CTX-M- 14 type. CONCLUSION The detection rates of E. coli and K. pneurnoniae producing CTX-M type ESBLs were higher, most of them were CTX-M-14 type; carbapenem are currently the most effective drugs to treat the bacteria producing ESBLs.

关 键 词：肠杆菌科 产超广谱Β-内酰胺酶 CTX-M 耐药性 基因型 

分 类 号：R378.2[医药卫生—病原生物学]