重症感染患儿产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌的表型和基因型分析  

Phenotype and genotype of extended-spectrumβ-lactamase-producing Escherichia coli and Klebsiella pneumoniae in children with severe infection

作　　者：吴春明[1] 刘三海 王丽佳 陈靓[1] 赵安静 郑金莲 叶小丹[1] 胡倩倩 WU Chun-ming;LIU San-hai;WANG Li-jia;CHEN Liang;ZHAO An-jing;ZHENG Jin-lian;YE Xiao-dan;HU Qian-qian(Department of Infectious Diseases,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市中医院感染科,浙江温州325000

出　　处：《中国妇幼保健》2023年第16期3006-3010,共5页Maternal and Child Health Care of China

基　　金：浙江省温州市医药卫生科学研究项目(2015A04)。

摘　　要：目的探究重症感染患儿产超广谱β-内酰胺酶(ESBLs)大肠埃希菌(E.coli)和肺炎克雷伯菌(KPN)的表型和基因型。方法收集2013年6月—2014年6月温州市中医院所有分离的E.coli和KPN各60株,比较产ESBLs-E.coli、产ESBLs-KPN对亚胺培南、头孢吡肟、头孢噻肟、环丙沙星、头孢西丁、头孢他啶、氨曲南、头孢哌酮、哌拉西林/他唑巴坦及阿米卡星药敏性的差异,并分析产ESBLs-E.coli、产ESBLs-KPN的基因型和同源性。结果60株E.coli检出产ESBLs菌株32株(53.33%);60株KPN检出产ESBLs菌株18株(30.00%)。60株E.coli中,产ESBLs-E.coli菌株对亚胺培南、头孢吡肟、头孢他啶、头孢哌酮、哌拉西林/他唑巴坦及阿米卡星的药物敏感性均>50%,分别为100.00%、61.11%、50.00%、66.67%、55.56%及72.22%;非产ESBLs-E.coli菌株对亚胺培南、头孢吡肟、头孢噻肟、环丙沙星、头孢西丁、头孢他啶、氨曲南、头孢哌酮、哌拉西林/他唑巴坦及阿米卡星的药物敏感性均>50%,分别为100.00%、85.71%、88.10%、76.19%、80.95%、80.95%、88.10%、80.95%、88.10%、80.95%及92.86%。除亚胺培南外,其余产ESBLs-KPN菌株对抗菌药物敏感性均低于非产ESBLs菌株,差异均有统计学意义(均P<0.05)。60株KPN中,产ESBLs-KPN对亚胺培南、头孢吡肟、头孢他啶、头孢哌酮、哌拉西林/他唑巴坦及阿米卡星的药物敏感性分别为100.00%、61.11%、50.00%、66.67%、55.56%、72.22%;非产ESBLs-KPN菌株中亚胺培南、头孢吡肟、头孢噻肟、环丙沙星、头孢西丁、头孢他啶、氨曲南、头孢哌酮、哌拉西林/他唑巴坦及阿米卡星的药物敏感性分别为100.00%、85.71%、88.10%、76.19%、80.95%、80.95%、88.10%、80.95%、88.10%、80.95%及92.86%。除亚胺培南外,其余产ESBLs-KPN对抗菌药物敏感性均低于非产ESBLs-KPN菌株,差异均有统计学意义(均P<0.05)。32株产ESBLs-E.coli基因型共检出1种TEM、3种CTX-M亚型、3种SHV亚型,其中10株产ESBLs-E.coli携带2�Objective To investigate the phenotype and genotype of extended-spectrumβ-lactamase(ESBLs)-producing Escherich⁃ia coli and Klebsiella pneumoniae in children with severe infection.Methods Collect 60 strains of Escherichia coli(E.coli)and Klebsiella pneumoniae(KPN)isolated in Wenzhou Hospital of Traditional Chinese Medicine from June 2013 to June 2014,and compare the ESBLs-E.ESBLs-KPN for imipenem,cefepime,cefotaxime,ciprofloxacin,cefoxitin,ceftazidime,aztreonam,cefoperazone,piperacillin/tazobactam,amikacin The differences in drug susceptibility were analyzed,and the genotypes and homology of ESBLs-E.coli and ESBLs-KPN were analyzed.Results 32 ESBLs-producing strains(53.33%)were detected in 60 E.coli strains;18 ESBLs-producing strains(30.00%)were detected in 60 KPN strains.Among the 60 strains of E.coli,the sensitivity of ESBLs-producing E.coli to imipenem,cefepime,ceftazidime,cefoperazone,piperacillin/tazobactam,and amikacin were all greater than 50%,and all these with 100.00%,61.11%,50.00%,66.67%,55.56%and 72.22%;imipenem,cefepime,cefotaxime,ciprofloxacin,cefoxime among non-ESBLs-E.coli-producing strains The drug sensitivities of acetaminophen,ceftazidime,aztreonam,cefoperazone,piperacillin/tazobactam,and amikacin were all greater than 50%,100.00%,85.71%,88.10%,76.19%,80.95%,80.95%,88.10%,80.95%,88.10%,80.95%,92.86%.Except for imipenem,the other ESBLs-producing Klebsiella pneumoniae strains were less sensitive to antibiotics than non-ESBLs-producing strains(P<0.05).Among the 60 KPN strains,the drug susceptibility of ESBLs-KPN to imipenem,cefepime,ceftazidime,cefoperazone,piperacillin/tazobactam,amikacin was 100.00%,61.11%,50.00%,66.67%,55.56%,72.22%;imi⁃penem,cefepime,cefotaxime,ciprofloxacin,cefoxitin,ceftazidime,aztreonam,cefoperazone among non-ESBLs-KPN-producing strains The drug sensitivities of,piperacillin/tazobactam and amikacin were 100.00%,85.71%,88.10%,76.19%,80.95%,80.95%,88.10%,80.95%,88.10%,80.95%,92.86%.Except for imipenem,the susceptibility of other ESBLs-KPN-producing strains to antibiotics w

关 键 词：超广谱Β-内酰胺酶 大肠埃希菌 肺炎克雷伯菌 基因型 

分 类 号：R725[医药卫生—儿科]