玉米剥皮机损伤不愈合性伤口感染大肠埃希菌耐药性及其耐药基因  

Drug resistance of Escherichia coli strains isolated from patients with corn husker-induced non-healing wound infection and drug resistance genes

作　　者：王泉 齐金红 孙文弢 李华 酉春霖 WANG Quan;QI Jin-hong;SUN Wen-tao;LI Hua;YOU Chun-lin(Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院手足外科,河北衡水053000 [2]河北医科大学第四医院检验科,河北石家庄050000

出　　处：《中华医院感染学杂志》2021年第13期2041-2045,共5页Chinese Journal of Nosocomiology

基　　金：河北省卫生健康委医学科学研究基金资助项目(20191774)。

摘　　要：目的探讨玉米剥皮机损伤不愈合性伤口感染大肠埃希菌耐药性及其耐药基因。方法收集2017年1月-2020年1月衡水市人民医院收治108例玉米剥皮机不愈合性伤口感染患者,根据损伤程度分为I型组(21例)、Ⅱ型组(24例)、Ⅲ型组(30例)、IV型组(33例),创面分离出所得大肠埃希菌菌株,纸片扩散法进行药敏试验,聚合酶链式反应(PCR)法检测大肠埃希菌耐药基因,比较不同损伤程度患者耐药基因分布情况。结果各组年龄、性别、学历情况、受伤部分、徒手操作以及C-反应蛋白(CRP)、干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)、自然杀伤细胞(NK)水平比较,无统计学差异,而治疗方式、住院时间比较有统计学差异(P<0.05);大肠埃希菌对庆大霉素、头孢噻肟、头孢他啶、氨曲南、阿米卡星的耐药率分别为67.59%、59.26%、51.85%、20.37%、10.19%,而对亚胺培南、美罗培南、头孢哌酮/舒巴坦具有高敏感性,均为100%;大肠埃希菌中TEM、CTX-M-9、CTX-M-55、qnrB、aac(3)-Ⅱ、aadA5检出率分为55.56%、46.30%、21.30%、19.44%、58.33%、51.85%;各组患者β-内酰胺类、喹诺酮类、氨基糖苷类耐药基因检出率比较,无统计学差异。结论大肠埃希菌对青霉素类、头孢菌素类、喹诺酮类、氨基糖苷类和β-内酰胺类抗菌药物存在耐药性,可能与携带相关类型耐药基因有关。OBJECTIVE To explore the drug resistance of Escherichia coli strains isolated from the patients with corn husker-induced non-healing wound infection and observe the drug resistance genes.METHODS A total of 108 patients with corn husker-induced non-healing wound infection who were treated in the Hengshui People’s Hospital from Jan 2017 to Jan 2020 were enrolled in the study and divided into the type I group with 21 cases,the typeⅡgroup with 24 cases,the typeⅢgroup with 30 cases,and the type IV group with 33 cases according to the degree of injury.The E.coli strains were isolated from wound secretions specimens,drug susceptibility testing was performed by means of disc diffusion method,drug resistance genes in the E.coli strains were detected by using polymerase chain reaction(PCR),and the drug resistance genes were compared among the patients with different degree of injury.RESULTS There were no significant differences in age,gender,education background,sites of injury,and bare-handed operation as well as levels of C-reactive protein(CRP),interferon-γ(IFN-γ),interleukin-6(IL-6)and natural killer(NK)cells among the four groups,however,there were significant differences in the treatment mode and length of hospital stay(P<0.05).The drug resistance rates of the E.coli strains to gentamicin,cefotaxime,ceftazidime,aztreonam and amikacin were 67.59%,59.26%,51.85%,20.37%and 10.19%,respectively,while the strains were highly sensitive to imipenem,meropenem and cefoperazone-sulbactam(100%).The detection rates of TEM,CTX-M-9,CTX-M-55,qnrB,aac(3)-Ⅱand aadA5 in the E.coli strains were respectively 55.56%,46.30%,21.30%,19.44%,58.33%and 51.85%;there were no significant differences in the detection rates ofβ-lactams-,quinolones-,and aminoglycosides-resistant genes among the four groups.CONCLUSION The isolated E.coli strains are resistant to penicillin,cephalosporins,quinolones,aminoglycosides andβ-lactams,which may be associated with its carrying with drug resistance genes.

关 键 词：玉米剥皮机 不愈合性伤口 伤口感染 大肠埃希菌 耐药性 耐药基因 

分 类 号：R641[医药卫生—外科学]