产超广谱β内酰胺酶大肠埃希菌耐药特征及基因分型  

Resistance and genotyping of extended-spectrum β-lactamase-producing Escherichia coli isolates

作　　者：潘玫[1] 李稳[1] 陈山[2] 张玉倩[1] 

机构地区：[1]山东中医药大学附属医院检验科,济南250011 [2]山东省立医院

出　　处：《中国感染与化疗杂志》2013年第2期132-135,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解山东中医药大学附属医院分离的大肠埃希菌中产超广谱β内酰胺酶(ESBLs)菌株的耐药特征及CTX-M型、TEM型、SHV型基因流行状况。方法采用双纸片法检测ESBLs,聚合酶链反应(PCR)检测CTX-M酶、TEM酶、SHV酶基因型DNA序列分析确认TEM及SHV基因亚型,K-B法进行药敏试验。结果 83株大肠埃希菌中45株ESBLs表型确证试验阳性,检出率为54.2%,PCR扩增结果显示83株大肠埃希菌中CTX-M型基因扩增阳性44株(53.0%),TEM型阳性32株(38.6%),SHV型阳性1株(1.2%),TEM型和SHV型测序结果分别为TEM-1亚型和SHV-1亚型。产ESBLs大肠埃希菌,除对亚胺培南、美罗培南未见耐药外,对阿米卡星、哌拉西林-他唑巴坦和头孢西丁耐药性较低,耐药率分别为13.3%、17.8%和31.1%,产ESBLs大肠埃希菌,除了对头孢菌素、单环β内酰胺类抗生素具有很高耐药性外,对甲氧苄啶-磺胺甲噁唑、左氧氟沙星、环丙沙星和庆大霉素具有较高耐药性,耐药率均高于60%。结论该院产ESBLs大肠埃希菌基因型以CTX-M型为主。产ESBLs大肠埃希菌呈现多重耐药趋势。Objective To detetct the production of extended spectrum β-lactamases （ESBLs） and the prevalence of CTX-M type, TEM-, SHV gene in E. coli. Methods Double-disk test and phenotypic confirmatory test were used to detect ESBLs in the E. coli strains isolated from clinical specimens. Polymerase chain reaction （PCR） was applied to identify CTX-M, TEM and SHV genotype. DNA sequence analysis was utilized to confirm the TEM and SHV gene subtypes. Results The overall prevalence of ESBLs producing strains in E. coli isolates was 54.2% （45/83）. CTX-M-type ESBLs was produced in 44 of 83 isolates （53.0G）, TEM type ESBLs in 32 of 83 isolates （38.6G）, and SHV type ESBLs in only 1 isolates （1.2%）. No imi penem- or meropenem-resistant strain was found. The ESBLs-producing strains showed lower resistance to amikacin, piperacil- lin-tazobaetam, cefepime. About 13.3%, 17.8%, 31.1% of the strains were resistant to these antibiotics, respectively. More than 60% of the ESBLs-producing strains were resistant to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin or gentamicin. Conclusions CTX-M group was the main ESBLs genotype. ESBLs-producing E. coli are usually multiple drug resistant.

关 键 词：大肠埃希菌 超广谱Β内酰胺酶 基因型 耐药特征 

分 类 号：R446.5[医药卫生—诊断学]