Ⅰ类整合酶与大肠埃希菌耐药关系的初步研究  

A preliminary study on the relationship between Class Ⅰ integrase and resistance of Escherichia coli

作　　者：徐琦煜[1] 周翠[1] 李超[1] 周铁丽[1] 李少禧[1] 吕美艳[1] 邹安庆[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000

出　　处：《中华医院感染学杂志》2012年第6期1111-1113,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院大肠埃希菌临床分离株的耐药性变迁及Ⅰ类整合酶在产与非产ESBLs大肠埃希菌中的分布状况,分析和评估Ⅰ类整合酶在该菌耐药中的作用。方法按CLSI 2010年标准,用K-B法进行药敏试验,双纸片协同法检测产ESBLs株,PCR法扩增Ⅰ类整合酶基因;数据经χ2检验进行统计学分析。结果 2006-2010年大肠埃希菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥因等耐药性较低,对其他各类的药物表现出较高的耐药率,未检出亚胺培南耐药株;部分菌株对氨基糖苷类药物的耐药性有稍下降的趋势;150株大肠埃希菌中104株Ⅰ类整合酶扩增阳性,产ESBLs菌株中Ⅰ类整合酶的检出率为71.8%,非产ESBLs菌株中检出率为66.6%,差异无统计学意义;Ⅰ类整合酶阳性菌株和阴性株对氨基糖苷类抗菌药物耐药率比较,差异有统计学意义(P<0.05)。结论医院大肠埃希菌5年中耐药性多呈轻度升高趋势,Ⅰ类整合酶与产ESBLs耐药无关,Ⅰ类整合酶阳性株对多种抗菌药物的耐药率大于整合酶阴性菌株,建议临床加强对大肠埃希菌耐药性的监测。OBJECTIVE To investigate the changes of antibiotic resistance of Escherichia coli isolates and the distribution of class Ⅰ integrase genome among all ESBL-producing and non-ESBL-producing E.coli isolates and to evaluate the association between class Ⅰ integrase and ESBL-producing organisms.METHODS The presence of ESBLs-producing isolates were determined by the standard double-disk synergy test according to CLSI 2010 and the class Ⅰ integrase genome was determined by Polymerase Chain Reaction（PCR） with integrase specific primer.Statistical significance for comparison proportions was calculated by the chi-square test.RESULTS These E.coli strains showed low rates of antibiotic resistance to imipenem,cefoperazone/sulbactam,piperacillin/tazobactam and nitrofurantoin but high rates to others antibiotics in past 5 years.However,imipenem showed good antimicrobial activity among all these strains.A slightly descendent tendency appeared in part of aminoglycosides.104 of 150 isolates were identified being positive for class Ⅰ integrase gene.The class Ⅰ integron was found among ESBL-producing（71.8%） and non-ESBL-producing（66.6%） E.coli strains（P0.05）.The aminoglycosides resistance of class 1 integrase gene positive strains were higher than that of the negative strains（P0.05）.CONCLUSION To most antibiotics,a slightly elevatory resistant tendency was showed in E.coli strains isolated from clinical patients in 5 years.Our experimental data shows that perhaps there were no relationships between integron-carrying and the ESBLs-producing in these strains.The antibiotics resistance for most of the integrase positive strains was higher than that of negative ones and surveillance for antibiotic resistance of these strains should be enhanced.

关 键 词：大肠埃希菌 Ⅰ类整合酶 超广谱Β-内酰胺酶 耐药 

分 类 号：R378.21[医药卫生—病原生物学]