绍兴某医院肠外气单胞菌对β-内酰胺类药物的耐药分析  

Analysis on β-lactam resistance in extraintestinal Aeromonas isolated from a hospital of Shaoxing

作　　者：何秋丽[1] 茅国峰[1] 梁美春[1] He Qiuli;Mao Guofeng;Liang Meichun(Clinical Laboratory Center,Shaoxing People's Hospital(Shaoxing Hospital,Zhejiang University),Shaoxing 312000, Zhejiang,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)临床检验中心,浙江绍兴312000

出　　处：《国际流行病学传染病学杂志》2019年第2期139-143,共5页International Journal of Epidemiology and Infectious Disease

基　　金：绍兴市公益性技术应用研究项目(20I5B70044).

摘　　要：目的了解绍兴市人民医院肠外气单胞菌β-内酰胺类耐药基因及整合子的分布情况,及其对耐药的影响.方法选取绍兴市人民医院2015年7月至2017年10月分离获得的50株肠外气单胞菌进行9种β-内酰胺类药物敏感性测试,分析携带β-内酰胺类耐药基因及整合子对菌株耐药的影响.结果 50株肠外气单胞菌对头孢菌素耐药率均在44.0%以上,对亚胺培南和美罗培南耐药率在4.0%以下.cphA和blaTEM基因主要存在于嗜水气单胞菌,分别占48.0%和36.0%;2株豚鼠气单胞菌中检测到blaIMP;未检测出blaVIM和blaSHV基因.cphA阳性菌株对头孢曲松、头孢吡肟、氨曲南的耐药率均超过60.0%,且显著高于阴性菌株(x2=4.711、4.121和13.936,P均<0.05).blaTEM阳性菌株对4种头孢药物和氨曲南的耐药率均超过65.0%,显著高于阴性菌株(x2=13.903、18.733、5.966、29.501和34.722,P均<0.05).intI1整合子基因阳性率50.0%,未检出intI2、intI3整合子基因.intI1阳性菌株4种头孢药物和氨曲南的耐药率均超过68.0%,显著高于阴性菌株(x2=17.014、23.727、11.688、32.051和29.639,P均<0.01).结论β-内酰胺类基因cphA和blaTEM在绍兴市人民医院分离的肠道外气单胞菌中较为常见,阳性菌株对头孢菌素类和单环β-内酰胺类药物的耐药性较高.intI1整合子是该院分离气单胞菌中最常见的整合子,其存在可显著提高气单胞菌对多种抗菌药物的耐药性.Objective To understand the distribution of resistance genes and integrons for β-lactams in extraintestinal Aeromonas spp.isolated from Shaoxing People's Hospital,and to analyze their effects on antibiotic resistance.Methods A total of 50 extraintestinal Aeromonas strains isolated from the patients in Shaoxing People's Hospital from July 2015 to October 2017 were analyzed for antibiotic sensitivity of 9 kinds of β-lactams.Resistance genes and integrons for β-1actams were analyzed for drug resistance of the strains.Results The 50 extraintestinal Aeromonas strains had resistance rates of over 44.0% to cephalosporins,and low resistance rates of under 4.0% to imipenem and meropenem.The cphA gene and blaTEM gene were mainly located in Aeromonas hydrophila,accounting for 48.0% and 36.0%,respectively.The blaIMP gene was detected in two strains of A eromonas caviae.No blaVIM or blaSHV gene was detected.The resistance rates of cphA gene positive strains to ceftriaxone(CRO),cefepime(FEP) and aztreonam (ATM) were all above 60.0%,which were significantly higher than those of negative strains (x2=4.711,4.121 and 13.936,P all<0.05).The resistance rates of blaTEM gene positive strains to 4 kinds of cephalosporins and ATM were all over 65.0%,which were significantly higher than those of negative strains (x2=13.903,18.733,5.966,29.501 and 34.722,P all<0.05).The positive rate of intI1 integron gene was 50.0%,while none of intI2 or intI3 integron gene was detected.The resistance rates of intI1 gene positive strains to 4 kinds of cephalosporins and ATM were all over 68.0%,which were significantly higher than those of negative strains (x2=17.014,23.727,11.688,32.051 and 29.639,P all<0.01).Conclusions The β-1actamase resistance gene cphA and blaTEM are common in the extraintestinal Aeromonas isolated from Shaoxing People's Hospital.The resistance of the positive strains to cephalosporins and monocycle β-lactamase antibiotics is significantly higher than that of the negative strains.intI1 integrons in these strains are the most co

关 键 词：Β内酰胺类 气单胞菌属 耐药 基因 整合子 

分 类 号：R446.5[医药卫生—诊断学]