CTX-M型超广谱β-内酰胺酶耐药基因流行性分析  

Prevalence analysis of drug resistant genes of CTX-M type extended-spectrumβ-lactamases

作　　者：董路宁 朱柯蕙 孙响 贾晨冉 段蕾 贾继民[1] DONG Lu-ning;ZHU Ke-hui;SUN Xiang;JIA Chen-ran;DUAN Lei;JIA Ji-min(Xinjiang Military Command Center for Disease Control and Prevention,Urumqi,Xinjiang 830011,China)

机构地区：[1]新疆军区保障部疾病预防控制中心,新疆乌鲁木齐830011

出　　处：《中国卫生检验杂志》2022年第22期2720-2723,共4页Chinese Journal of Health Laboratory Technology

基　　金：军队肠道传染病病原监测项目。

摘　　要：目的 了解临床分离肠道病原菌中产ESBLs菌株的发生率、流行特征及产CTX-M型耐药表型和基因型。方法 对临床分离到的93株肠道病原菌进行ESBLs表型确证试验;采用聚合酶链反应(PCR)检测CTX-M基因,对PCR产物测序并确定基因亚型;采用K-B琼脂扩散法对23种抗菌药物的耐药性进行检测。结果 93株肠道病原菌中有53株(57.0%)ESBLs表型检测阳性。PCR扩增结果表明,共有16株(30.2%)携带CTX-M型基因,其中5株(31.2%)检出CTX-M-1组基因,11株(68.8%)检出CTX-M-9组基因。基因测序确定存在CTX-M-3、CTX-M-14、CTX-M-15、CTX-M-24、CTX-M-55、CTX-M-65等多种亚型,以CTX-M-65为主。药敏结果显示不同基因型药物敏感性有所不同,但均对青霉素类,第一代、二代、三代头孢类抗生素有较为明显的抗药性。结论 乌鲁木齐地区肠道病原菌产ESBLs现象较为普遍,对氨苄西林、头孢唑啉、头孢噻吩和头孢呋辛高度耐药。细菌基因型以CTX-M-65亚型为主,同时存在多种亚型。Objective This study aims to investigate the prevalence of extended spectrum beta-lactamases(ESBLs)and study the epidemiological characteristics,and to identify the type of CTX-M-producing encoding gene and its resistance phenotype.Methods Ninety three strains of multi-resistant Enterobacteriaceae isolates were collected for the verification of ESBLs-producing isolates by means of phenotypic confirmatory tests.The CTX-M gene was detected by polymerase chain reaction(PCR).The PCR products were sequenced and the gene subtypes were determined.K-B agar diffusion method was used to detect the resistance of 23 antibiotics.Results Among 93 intestinal pathogens,53(57.0%)were positive for ESBLs phenotype.The results of PCR amplification showed that a total of 16 strains(30.2%)carried CTX-M gene,among which 5 strains(31.2%)were identified with CTX-M-1 gene,and 11 strains(68.8%)were identified with CTX-M-9 gene.Gene sequencing confirmed the existence of CTX-M-3,CTX-M-14,CTX-M-15,CTX-M-24,CTX-M-55,CTX-M-65 and other subtypes,and CTX-M-65 was the main one.Drug susceptibility results showed that different genotypes had different drug susceptibility,but all of them had obvious resistance to penicillins,first generation,second generation and third generation cephalosporins.Conclusion ESBLs production by intestinal pathogens is common in Urumqi and highly resistant to ampicillin,cefazolin,cefalothiophene and cefuroxime.Bacterial genotypes were mainly CTX-M-65 subtype,and many subtypes were observed.

关 键 词：肠道病原菌 超广谱Β-内酰胺酶 CTX-M基因 耐药性 

分 类 号：R446[医药卫生—诊断学]