临床分离产超广谱β-内酰胺酶大肠埃希菌耐药性分析及相关基因研究  

Study on drug-resistant phonotype and genes in ESBLs-producing Escherichia coli from clinical isolates

作　　者：袁星[1] 蒋斌[1] 曹雷 YUAN Xing;JIANG Bin;CAO Lei(Department of Medical College,Hefei Technology College,Hefei 238000,China)

机构地区：[1]合肥职业技术学院医学院,安徽合肥238000 [2]合肥市第八人民医院检验科

出　　处：《华北理工大学学报（医学版）》2020年第5期341-347,共7页Journal of North China University of Science and Technology：Health Sciences Edition

基　　金：高职教育创新-医学检验技术骨干专业项目建设(编号:XM-01-4);安徽省高水平高职专业-医学检验技术(编号:2018ylzy146);微生物检验大规模在线开放课程示范项目(编号:2019dgmkc005);安徽省教育厅重点科研项目-大肠杆菌-酵母菌穿梭克隆载体的构建及应用研究(编号:KJ2019A1125)。

摘　　要：(1)目的调查由医院分离出的大肠埃希菌耐药谱,探求产超广谱β-内酰胺酶(ESBLs)大肠埃希菌相关耐药基因及其作用机制。(2)方法对2018年医院分离菌株鉴定应用VITEK系统,采用Kirby-Bauer纸片扩散法进行药敏试验,ESBLs相关基因CTX-M、TEM、SHV和OXA等使用PCR扩增。药敏结果采用WHONET 5.6软件分析。(3)结果 2018年在临床标本中一共检出136株大肠埃希菌,其中81株为产ESBLs大肠埃希菌,占比为59.6%;药敏结果显示大肠埃希菌,尤其是产ESBLs大肠埃希菌对头孢菌素类和其他常用抗菌药物的耐药性较高。81株产酶菌株PCR均扩增出了相关基因产物,其中CTX-M型基因扩增阳性为57株(70.4%),且以CTX-M 9为主,有36株为该型;TEM型阳性20株(24.7%);混合型检出了4株(4.9%);未检出SHV和OXA型菌株。(4)结论产ESBLs大肠埃希菌对常用抗菌素的耐药率较高,且呈现多重耐药趋势。产酶菌株基因型以CTX-M为主,且以CTX-M 9居多。Objective To investigate drug resistance of Escherichia coli strains and to analysis the genetic mechanisms of ESBLs-producing Escherichia coli by aid of molecular methods.Methods Bacteria isolated from the hospital in 2018,were identified by VITEK system, the results of antibiotics susceptibility test was determined by using K-B disk diffusion method.We amplified genes of CTX-M、TEM、SHV and OXA by PCR, and analyzed clinical isolates based on WHONET5.6 software.Results There were 136 strains of Escherichia coli species were collected in 2018, 81 strains were posttive for ESBLs phonotype, accounting for 59.6%;The antibiotics resistance rate of Escherichia coli isolates to cephalosporins and other antimicrobials was high, ESBLs(+)bacterium generally had a higher drug tolerance rate than that of ESBLs(-)bacterium, which had statistical significance.PCR indicated that among the 81 strains of ESBLs-producing E.coli, there were 57 strains of CTX-M(70.4%), and to CTX-M 9-based, there were 36 plants for this type, 20 strains of TEM(24.7%)and 4 strains of both CTX-M and TEM(4.9%), SHV and OXA strains were not detected.Conclusion The current drug-resistance rate among ESBLs-producing Escherichia coli strains is high to common antibiotics in Hefei city of China, Enzyme-producing strains are mainly CTX-M, and CTX-M 9 are the most dominant.

关 键 词：大肠埃希菌 抗菌药物 超广谱Β-内酰胺酶 耐药基因 

分 类 号：R446[医药卫生—诊断学]