泌尿科住院患者大肠埃希菌及尿肠球菌耐药基因检测与分析  

Detection and analysis of drug resistance genes in Escherichia coli and Enterococcusin patients in Urology

作　　者：于浩[1] 李连友[1] 毛颖佳 张大鹏[2] 田野[2] YU Hao;LI Lian-you;MAO Ying-jia;ZHANG Da-peng;TIAN Ye(Laboratory and 2.Urolo-gy,Chifeng Hospital,Chifeng,Inner Mongolia,024000,China)

机构地区：[1]赤峰市医院检验科,内蒙古赤峰024000 [2]赤峰市医院泌尿外科

出　　处：《中国病原生物学杂志》2018年第7期770-773,共4页Journal of Pathogen Biology

摘　　要：目的分析泌尿系患者感染大肠埃希菌及尿肠球菌的耐药性及其耐药基因分布情况,为临床治疗及耐药性控制提供科学依据。方法收集2015年6月-2017年5月本院收治泌尿系感染患者的送检标本经琼脂平板法培养分离的大肠埃希菌124株,尿肠球菌68株,采用K-B法对分离菌进行耐药性分析;应用聚合酶链反应(PCR)扩增耐药基因并测序,分析耐药基因分布情况。结果 K-B法测定大肠埃希菌分离株耐药率分别为:诺氟沙星24.20%、氧氟沙星14.52%、环丙沙星8.87%、阿米卡星16.94%、美罗培南0.81%、亚胺培南1.61%、庆大霉素61.29%、四环素32.26%;PCR扩增IMP(587bp)基因、TEM(535bp)基因、CTX-M-1(891bp)基因、SHV(305bp)基因、NDM-1(287bp)基因、aac(3)-Ⅱ(237bp)基因、ant(3″)-Ⅰ(284bp)基因、aac(6′)-Ⅰ(394bp)基因阳性率分别为9.68%、60.48%、40.32%、11.29%、4.03%、46.77%、29.03%和50.81%。尿肠球菌耐药率分别为:诺氟沙星64.70%,氧氟沙星61.77%,环丙沙星57.35%,四环素58.82%,、氯霉素47.06%,庆大霉素75.00%,红霉素66.18%,利福平47.06%,对万古霉素和替考拉宁均敏感;PCR扩增ant(6)-Ⅰ(460)基因、aac(6′)-Ⅰ(394bp)基因、aph(3)-Ⅲ(370)基因、efm(1090)基因、efa(940)基因、ermB(920)基因、tetM(770)基因阳性率分别为57.35%、73.53%、32.35%、60.29%、51.47%、36.76%和8.2%。结论泌尿系统感染患者感染的大肠埃希菌对氨基糖苷类抗生素耐药性较高。尿肠球菌除对万古霉素及替考拉宁敏感外,对其它常用抗生素耐药性也较高,且耐药性与耐药基因分布密切相关。因此对于泌尿科患者的抗感染治疗应根据药敏试验结果用药,耐药基因检测也有一定指导意义。Objective To analyze the drug resistance of Escherichia coli and Enterococcus faeciumin patients with a urinary infection and the distribution of drug resistance genes in order to provide a scientific basis for clinical treatment of those infections and control of their drug resistance. Methods Specimens were collected patients with a urinary infection in this Hospital from June 2015 to May 2017.One hundred and twenty-four strains of E.coli and 68 strains of E.faecium were isolated using a conventional agar culture.Drug resistance was analyzed using the K-B method.PCR was used to amplify and sequence drug resistance genes and to analyze the distribution of those genes. Results E.coli was resistant to norfloxacin at a rate of 24.20%,to ofloxacin at a rate of 14.52%,to ciprofloxacin at a rate of 8.87%,to amikacin at a rate of 16.94%,to meropenem at a rate of 0.81%,to imipenem at a rate of 1.61%,to gentamicin at a rate of 61.29%,and to tetracycline at a rate of 32.26%.Resistance genes were amplified with PCR.The IMP（587 bp）gene was detected at a rate of 9.68%,the TEM（535 bp）gene was detected at a rate of 60.48%,the CTX-M-1（891 bp）gene was detected at a rate of 40.32%,the SHV（305 bp）gene was detected at a rate of 11.29%,the NDM-1（287 bp）gene was detected at a rate of 4.03%,the aac（3）-II（237 bp）gene was detected at a rate of 46.77%,the ant（3＂）-I（284 bp）gene was detected at a rate of 29.03%,and the aac（6＇）-I（394 bp）gene was detected at a rate of 50.81%.E.faecium was resistant to norfloxacin at a rate of 64.70%,to ofloxacin at a rate of 61.77%,to ciprofloxacin at a rate of 57.35%,to tetracycline at a rate of 58.82%,to chloramphenicol at a rate of 47.06%,to gentamicin at a rate of 75.00%,to erythromycin at a rate of 66.18%,to vancomycin at a rate of 0.00%,to rifampin at a rate of 47.06%,and to teicoplanin at a rate of 0.00%.As a result of amplification with PCR,the ant（6）-I（460）gene was detected at a rate of 57.35%,the aac（6＇）-I（394 bp）gene was detected at

关 键 词：泌尿科 大肠埃希菌 尿肠球菌 耐药性 基因 

分 类 号：R378.21[医药卫生—病原生物学]