社区泌尿系感染大肠埃希菌ESBL和PMQR基因分析  

Analysis of ESBL and PMQR genes of Escherichia coli isolated from community patients with urinary tract infections

作　　者：许翠英 曹梅 方爱国 XU Cuiying;CAO Mei;FANG Aiguo(Department of Nosocomial Infection and Disease Control,Fengxian District Centre Hospital,Shanghai 201499,China;Department of Laboratory Medicine,Fengxian District Centre Hospital,Shanghai 201499,China;Department of General Practice,Fengcheng Sub-district Community Health Service Center,Shanghai 201411,China)

机构地区：[1]上海市奉贤区中心医院院内感染与疾病控制处,上海201499 [2]上海市奉贤区中心医院检验科,上海201499 [3]上海市奉贤区奉城镇社区卫生服务中心全科医学科,上海201411

出　　处：《国际检验医学杂志》2022年第S01期33-38,共6页International Journal of Laboratory Medicine

基　　金：奉贤区(社会类)科技发展基金(20151001)。

摘　　要：目的 探索社区泌尿系感染大肠埃希菌耐药性与超广谱β-内酰胺酶(ESBL)和质粒介导喹诺酮耐药(PMQR)基因的关系。方法 回顾性研究2015年11月至2018年12月非重复分离自本院门诊就诊患者尿液样本的大肠埃希菌152株,采用Phoenix 100全自动微生物分析仪进行细菌鉴定及药敏分析。PCR筛查ESBL基因(blaTEM,blaSHV,blaCTX-M-1,blaCTX-M-2,blaCTX-M-8,blaCTX-M-9,blaCTX-M-25和blaOXA-1)和PMQR基因(qnrA、qnrB、qnrC、qnrD、qnrS、oqxA、oqxB、qepA和aac(6′)-1b),分析大肠埃希菌耐药性与ESBL和PMQR基因的关系。结果 152株大肠埃希菌中102株携带ESBL基因,以blaTEM-1和blaCTX-M-14为主,ESBL基因阳性组对常用头孢菌素类耐药率高于阴性组,差异有统计学意义(P<0.05);23株携带PMQR基因,PMQR基因阳性组对环丙沙星和左氧氟沙星的耐药率高于阴性组,差异有统计学意义(P<0.05)。结论 社区泌尿系感染大肠埃希菌ESBL基因和PMQR基因与细菌耐药性密切相关。blaTEM-1和blaCTX-M-14是本院大肠埃希菌对β-内酰胺类抗菌药物耐药的主要原因。Objective To explore the relationship of antimicrobial resistance with extended-spectrumβ-lactamases(ESBL)and plasmid-mediated quinolone resistance(PMQR)genes in Escherichia coli isolated from community patients with urinary tract infections.Methods From November 2015 to December 2018,152 isolates of Escherichia coli that collected without repetition from the urine samples of outpatients in Fengxian district centre hospital were studied retrospectively.Bacterial identification and antimicrobial susceptibility analysis was carried out by Phoenix 100 automatic microbiological analyzer.The ESBL genes(blaTEM,blaSHV,blaCTX-M-1,blaCTX-M-2,blaCTX-M-8,blaCTX-M-9,blaCTX-M-25 and blaOXA-1)and PMQR genes(qnrA、qnrB、qnrC、qnrD、qnrS、oqxA、oqxB、qepA and aac(6′)-1b)were screened by PCR.The relationship of antimicrobial resistance of Escherichia coli with ESBL and PMQR genes was analyzed.Results Among 152 Escherichia coli,102 isolates carried ESBL genes,mainly blaTEM-1 and blaCTX-M-14.The resistance rates of ESBL genes positive group to commonly used cephalosporins were higher than those of negative group,the difference was statistically significant(P<0.05).Twenty-three isolates carried PMQR genes.The resistance rates of PMQR genes positive group to ciprofloxacin and levofloxacin were higher than those of negative group,the difference was statistically significant(P<0.05).Conclusion ESBL and PMQR genes were closely related to antimicrobial resistance in E.coli isolated from community patients with urinary tract infection.blaTEM-1 and blaCTX-M-14 were the main reasons of resistance of Escherichia coliβ-lactam antimicrobial agents in our hospital.

关 键 词：大肠埃希菌 耐药性 超广谱Β-内酰胺酶 质粒介导喹诺酮耐药 

分 类 号：R44[医药卫生—诊断学]