皖江地区产ESBLs大肠埃希菌和肺炎克雷伯菌基因型及耐药性分析  

Analysis of Genotypes and Antibiotic Resistance on ESBLs-producing Escherichia Coli and Klebsiella Pneumoniae in Anhui Province

作　　者：凌华志[1] 徐元宏[1] 王中新[1] 沈继录[1] 浦春[2] 郝维敏[3] 

机构地区：[1]安徽医科大学第一附属医院检验科,合肥230022 [2]皖南医学院弋矶山医院检验科 [3]安徽省宿州市立医院检验科

出　　处：《临床输血与检验》2014年第1期11-15,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：安徽医科大学第一附属医院国家自然科学基金培育计划项目(No.2011KJ07)资助

摘　　要：目的研究安徽省芜湖及宿州两地临床产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率、基因型分布及对抗菌药物的耐药性。方法收集两地大肠埃希菌和肺炎克雷伯菌进行ESBLs确证试验;采用PCR法对产ESBLs株进行β内酰胺酶基因的扩增;微量稀释法测定产ESBLs株对13种抗菌药物的耐药率。结果两地大肠埃希菌和肺炎克雷伯菌ESBLs检出率的差异均无统计学意义(P>0.05),但基因型存在一定差异。bla(TEM)+bla(CTX-M-13)是最常见的基因检出模式。两地产ESBLs株对抗菌药物表现出不同的耐药率,但对亚胺培南和美洛培南均100%敏感。结论芜湖和宿州地区产ESBLs大肠埃希菌和肺炎克雷伯菌存在较严重的抗菌药物选择性压力;酶抑制剂复合制剂及碳青酶烯类是治疗产ESBLs大肠埃希菌和肺炎克雷伯菌感染的理想药物。）Objective To study the detection rate,genotype and antibiotic resistance on clinical isolates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae in Wuhu and Suzhou,Anhui.Methods The confirmation test was used to detect ESB-producing bacteria strains.PCR method was used to amplify beta-lactamases of the isolates.And the MICs to 13 antimicrobials against ESBLs-producing E.coli and K.pneumoniae were determined by microdilution method.Results There was no statistical significance of differences for ESBLs-producing E.coli and K.pneumoniae detection between the two regions.The bla（TEM）＋bla（CTX-M-13） was the most common genotype.The drug resistance rates of ESBLs-producing bacteria differed in areas and all bacterias showed sensitivity to IMP and MER.Conclusions Antibiotic selection pressure was serious in ESBLs-producing E.coli and K.pneumoniae in the regions.The compounds of enzyme inhibitor and Carbapenems were ideal agents to treat infections of ESBLs-producing E.coli and K.pneumoniae.

关 键 词：超广谱Β内酰胺酶 耐药性 大肠埃希菌 肺炎克雷伯菌 

分 类 号：R446.5[医药卫生—诊断学] R378[医药卫生—临床医学]