儿科患者感染大肠埃希菌耐药性及其对碳青霉烯类和氨基糖苷类药物耐药机制研究  

Analysis of the drug resistance of Escherichia coli infecting pediatric patients and its mechanisms of drug resistance research on carbapenems and aminoglycosides

作　　者：高杰[1] 李英[1] 王文英[1] 

机构地区：[1]河南大学淮河医院儿科,河南开封475000

出　　处：《中国病原生物学杂志》2016年第2期164-168,共5页Journal of Pathogen Biology

摘　　要：目的研究儿科患者感染大肠埃希菌的耐药性及其对碳青霉烯类和氨基糖苷类药物的耐药机制,为临床治疗及耐药性控制提供科学指导。方法收集2014年1月至2014年12月本院儿科患者的临床标本,从中分离大肠埃希菌114株,然后采用K-B法进行药敏试验,并用PCR法检测耐药基因分布情况。结果药敏试验测定大肠埃希菌对各抗菌药物的耐药率从高到低分别为链霉素57.89%,妥布霉素54.39%,庆大霉素44.74%,卡那霉素32.46%,亚胺培南17.54%,阿米卡星14.91%,美罗培南0.00%。PCR扩增大肠埃希菌OXA-51型酶基因、ant(3′′)-Ⅰ基因及aph(3′)-Ⅰ基因均阴性;OXA-23基因(796bp),CTX-M-1基因(833bp),NDM-1基因(386bp),aac(3)-Ⅱ基因(237bp),IMP基因(587bp)和aac(6′)-Ⅰ基因(394bp)扩增阳性率分别为9.65%、29.82%、18.42%、52.63%、20.18%,和12.28%。结论儿科患者感染大肠埃希菌临床分离株对氨基糖苷类抗生素的耐药程度高于碳青霉烯类抗生素,这与菌株内不同耐药基因的分布情况有关。Objective The drug resistance of Escherichia coli infecting pediatric patients and its mechanisms of resistance to carbapenems and aminoglycosides were studied to provide scientific guidance for clinical treatment of infections and control of drug resistance. Methods Samples were collected from pediatric patients at this Hospital from January to December 2014.In total,114 strains of E.coli were isolated.A drug sensitivity test was performed using the K-B method.The distribution of drug resistance genes was detected with PCR. Results Drug susceptibility analysis revealed that the resistance of E.coli to streptomycin was 57.89%,its resistance to tobramycin was 54.39%,its resistance to gentamicin was 44.74%,its resistance to kanamycin was 32.46%,its resistance to imipenem was 17.54%,its resistance to amikacin was 14.91%,and its resistance to meropenem was 0.00%.Amplification with PCR failed to reveal the presence of the OXA-51 gene,the ant（3＇）-I gene,or the aph（3＇）-I gene of E.coli.The OXA-23 gene was 796 bp in size and the fragment was detected in 9.65% of samples,the CTX-M-1gene was 833 bp in size and the fragment was detected in 29.82%of samples,the NDM-1gene was 386 bp in size and the fragment was detected in 18.42% of samples,the aac（3）-II gene was 237 bp in size and the fragment was detected in 52.63% of samples,the IMP gene was 587 bp in size and the fragment was detected in 20.18% of samples,and the aac（6＇）-I gene was 394 bp in size and the fragment was detected in 12.28% of samples. Conclusion Clinical isolates of E.coli infecting pediatric patients had greater resistance to aminoglycosides than to carbapenems,and this might be related to the distribution of different drug resistance genes among strains.

关 键 词：儿科患者 大肠埃希菌 耐药性 耐药基因 

分 类 号：R378.21[医药卫生—病原生物学]