安徽地区PMQR基因阳性大肠埃希菌和肺炎克雷伯菌中ESBLs流行特征的研究  

The epidemic features of ESBLs in PMQR genes positive Escherichia coli and Klebsiella pneumoniae in Anhui province

作　　者：陈聪[1] 叶英[1] 江洋[1] 许伟伟[1] 董秋萍[1] 

机构地区：[1]安徽医科大学第一附属医院感染科,合肥230032

出　　处：《中国抗生素杂志》2013年第3期239-240,I0004,共3页Chinese Journal of Antibiotics

基　　金：教育部科学技术研究重点项目(209059);安徽省优秀青年科技基金(08040106815);安徽省人事厅;卫生厅人才基金资助项目

摘　　要：目的了解安徽地区临床分离含质粒介导的喹诺酮类耐药基因(PMQR)大肠埃希菌和肺炎克雷伯菌中编码超广谱β-内酰胺酶(ESBLs)的基因型别,及与PMQR基因在本地区共同传播的流行现状和耐药特征。方法采用琼脂稀释法测定40株临床分离含PMQR基因的大肠埃希菌与肺炎克雷伯菌对临床14种抗菌药物的药物敏感性,CLSI表型确证试验进行表型鉴定,PCR检测blaESBLs基因型;接合实验验证PMQR与blaESBLs基因的转移性;ERIC-PCR进行同源性分析。结果 40株PMQR阳性菌株对喹诺酮类药物显示耐药同时对多种β-内酰胺类药物耐药;PCR法检测PMQR阳性菌株中blaESBLs基因携带率达到60%(24/40),最常见的为CTX-M型ESBLs,检出率达到92%(22/24)。结论安徽地区临床存在PMQR与blaESBLs基因的共同传播及流行,包含PMQR基因的菌株多为产ESBLs菌株,同时携带PMQR与blaESBLs基因的菌株常为多药耐药菌。Objective This study was designed to evaluate the occurrence and genotypic distribution of ESBLs producing in plasmid-mediated quinolone resistance （PMQR）-positive strains as well as to investigate the genetic relationship of the PMQR genes and blaEsaLs E. coli and K. pneumoniae clinical isolates in Anhui, China. Methods Antibiotic susceptibility test was performed using the agar dilution method. ESBL production was determined by the CLSI ESBL phenotypic confirmatory tests.The presence and type of ESBL in PMQR positive strains were determined by polymerase chain reaction （PCR） and nucleotide sequencing. Conjugation experiments were performed to determine whether the PMQR and blaEsaLs genes were self-transferable. The epidemiological relationship between positive isolates was studied by ERIC-PCR. Results The strains displayed high rates of resistance both to β-1actams and fluoroquinolones. PMQR-positive strains showed high positive rates （60%, 24/40） of blaEsBLs. The most frequent ]3-1actamase type was cefotaximase （CTX-M,92%）. Conclusion A high prevalence of CTX-M type 13-1actamase was detected in PMQR positive E. coli and K. pneumoniae strains. This study also identified the co-existence and transmission of PMQR genes and blaEsBLs in Anhui province. The co-expression of PMQR genes with blaEsBLs may lead to a serious public health problem.

关 键 词：ESBLS PMQR 大肠埃希菌 肺炎克雷伯菌 

分 类 号：R378.2[医药卫生—病原生物学]