某医院住院儿童产超广谱β-内酰胺酶大肠埃希菌分布及耐药性分析  

Distribution and drug resistance of extended spectrum β-lactamases Escherichia coli of inpatient children in a hospital

作　　者：刘畅 刘光亮[1] 翁晓文[1] LIU Chang;LIU Guangliang;WENG Xiaowen(Department of Pediatrics,Binhai County People's Hospital,Yancheng 224500,China)

机构地区：[1]滨海县人民医院儿科,江苏盐城224500

出　　处：《现代医学》2018年第11期1252-1255,共4页Modern Medical Journal

摘　　要：目的:了解住院儿童产超广谱β-内酰胺酶(extended-spectrumβ-lactamases,ESBLs)大肠埃希菌(Escherichia coli,ECO)分布、耐药及耐药基因分布情况,为临床治疗感染大肠埃希菌儿童提供依据。方法:采用VITEK-32微生物分析系统对98株大肠埃希菌进行鉴定,采取纸片扩散法进行ESBLs表型检测,对51株产ESBLs大肠埃希菌用K-B纸片法检测菌株的药敏情况,采用聚合酶链反应技术(PCR)检测菌株的耐药基因。结果:(1)共分离大肠埃希菌98株,以婴幼儿期检出最高;标本来源以深部痰为主,占63. 2%,其次是咽拭子和尿液,分别占10. 2%和8. 1%。(2) ESBLs的检出率为52. 0%,产酶株对氨苄西林、头孢唑啉和头孢噻肟耐药率达100%,未检出亚胺培南耐药株。(3)耐药基因intl1携带率为88. 2%,ampC携带率为78. 4%,tem携带率为49. 0%,acc、DHA1、NDM、fox均未检出。携带2种和3种耐药基因的菌株分别占82. 4%和37. 3%。结论:感染大肠埃希菌儿童以婴幼儿为主;大肠埃希菌产ESBLs率高,耐药形势严峻,耐药模式复杂;加强对大肠埃希菌耐药的监控具有非常重要的理论和实际意义。Objective:To study distribution,drug resistance and the distribution of genotypes resistant of Escherichia coli producing extended spectrum β-lactamase so as to provide reference for the diagnosis and treatment of children with infection.Methods:The VITEK-32 was used to identify 98 strains of Escherichia coli and ESBLs were detected with disc diffusion test.The antimicrobial susceptibility of 51 strains of Escherichia coli producing ESBLs was determined using strain K-B method and resistance genes were detected by polymerase chain reaction (PCR).Results:(1)A total of 98 strains of Escherichia coli were isolated,the highest rate was detected in infantile period.The main source of the specimen was the deep phlegm,accounting for 63.2%,followed by swabs and urine,accounting for 10.2% and 8.1% respectively.(2)The detection rate of ESBLs was 52.0%.The resistant rate of ampicillin,cefazolin and cefotaxime was as high as 100%,and no imipenem resistant strain was detected.(3)Drug resistance gene detection showed that intl1 carrier rate was 88.2%,ampC carrier rate was 78.4%,TEM carrier rate was 49.0%,acc,DHA1,NDM,fox were not detected.Strains carrying 2 and 3 resistance genes accounted for 82.4% and 37.3% respectively.Conclusion:The majority of children infected with Escherichia coli are mainly infants.The rate of producing ESBLs is high,the situation of drug resistance is severe,and the drug resistance pattern is complex.Strengthening drug resistance monitoring is of great theoretical and practical significance.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R197.323.4[医药卫生—卫生事业管理] R72[医药卫生—公共卫生与预防医学]