大肠埃希菌临床连续分离株常见耐药元件检测与分析  

Common drug resistance elements of clinical continuous isolates of Escherichia coli

作　　者：茅孝莹 许小敏[2] 陈琳[2] 常燕子[1] 糜祖煌[3] 

机构地区：[1]宁波市医疗中心李惠利医院检验科,浙江宁波315040 [2]宁波市第二医院医院感染管理科,浙江宁波315010 [3]无锡市克隆遗传技术研究所,江苏无锡214023

出　　处：《中华医院感染学杂志》2017年第21期4801-4804,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划资助项目(2014KYA197);宁波市科技局社发择优委托项目(2011C51002)

摘　　要：目的调查一组60株大肠埃希菌临床连续分离株常见耐药元件的携带情况和菌株间的亲缘性。方法收集2015年10月-12月医院住院患者分离的60株大肠埃希菌临床连续分离株,采用K-B法测定12种抗菌药物的敏感性,再用聚合酶链反应(PCR)及序列分析法分析15种β-内酰胺类、6种氨基糖苷类、3种磺胺类耐药相关基因以及4种可移动遗传元件遗传标记,并对检测结果作样本聚类分析。结果 60株大肠埃希菌对氨苄西林、庆大霉素、妥布霉素、环丙沙星、磺胺甲噁唑/甲氧苄啶耐药率>50%,对其它7种抗菌药物的耐药率<15%,对碳青霉烯类均敏感;60株菌共检出常见耐药元件基因15种,其中43株检出β-内酰胺类耐药基因,检出率为71.7%,33株检出氨基糖苷类耐药基因,检出率为55.0%,40株检出磺胺类耐药基因,检出率为66.7%,42株检出可移动遗传元件遗传标记基因,检出率为70.0%;共检出6种β-内酰胺类耐药基因,4种氨基糖苷类耐药基因,3种磺胺类耐药基因,2种可移动遗传元件遗传标记基因;样本聚类分析提示本组菌疑似存在8个克隆株,同一克隆内菌株携带着相同耐药元件,存在医院內感染。结论 blaTEM、aac(3)-Ⅱ、sul1、dfrA17、intⅠ1是导致本组菌株对β-内酰胺类、氨基糖苷类和磺胺类药物耐药的重要原因,耐药表型与基因型相符率高。OBJECTIVE To investigate the drug resistance elements of 60 clinical continuous isolates of Escherichia coli and analyze the phylogenetic relationship among the strains.METHODS A total of 60 clinical continuous isolates of E.coli were isolated from the patients who were hospitalized from Oct 2015 to Dec 2015,the drug susceptibility rates to 12 antibiotics were determined by using K-B method,the related genes resistant to 15β-lactams,6 aminoglycosides and 3 sulfonamides as well as 4 mobile genetic elements and genetic markers were analyzed by means of polymerase-chain-reaction（PCR）and sequencing analysis;the sample cluster analysis was performed for the results of detection.RESULTS The drug resistance rates of the 60 strains of E.coli to ampicillin,gentamicin,tobramycin,ciprofloxacin and sulfamethoxazole-trimethoprim were more than 50%,the drug resistance rates to other 7 antibiotics were more than 50%,and all of the strains were susceptible to carbapenems.Totally 15 types of drug resistance elements genes were detected in the 60 strains of E.coli,theβ-lactams resistance genes were detected in 43 strains,with the detection rate 71.7%;the aminoglycosides resistance genes were detected in 33 strains,with the detection rate 55.0%;the sulfonamides resistance genes were detected in 40 strains,with the detection rate 66.7%;the mobile genetic elements and genetic markers genes were detected in 42 strains,with the detection rate 70.0%.Totally 6 types ofβ-lactams resistance genes,4 types of aminoglycosides resistance genes,3 types of sulfonamides resistance genes and 2 types of mobile genetic elements and genetic marker genes were detected.The sample cluster analysis showed that there were 8 suspected clone strains in this group of strains,the strains of the same clone carried with the same drug resistance elements,suggesting that nosocomial infection sexisted.CONCLUSIONblaTEM,aac（3）-Ⅱ,sul1,dfrA17 and intⅠ1 are the leading causes of the resistance of this groups of strains toβ-lactams,aminoglycosides and su

关 键 词：大肠埃希菌 耐药 耐药基因 Β-内酰胺类 氨基糖苷类 样本聚类分析 

分 类 号：R378.21[医药卫生—病原生物学]