结直肠癌术后切口感染患者分离产ESBLs大肠埃希菌耐药性及分子分型  

Drug resistance and molecular types of ESBLs-producing Escherichia coli strains isolated from colorectal cancer patients with postoperative incision infection

作　　者：王晓驰 顾晓会 赵丽[3] 王艳文 盛丹 邹萌 WANG Xiao-chi;GU Xiao-hui;ZHAO Li;WANG Yan-wen;SHENG Dan;ZOU Meng(Shengjing Hospital of China Medical University,Shenyang,Liaoning110000,China)

机构地区：[1]中国医科大学附属盛京医院第四第八普通外科结直肠肿瘤肛门外科病房,辽宁沈阳110000 [2]中国医科大学附属盛京医院第三普通外科胃肠营养外科皮肤科病房,辽宁沈阳110000 [3]中国医科大学附属盛京医院第五骨科创伤骨科病房,辽宁沈阳110000 [4]中国医科大学附属盛京医院第二泌尿外科病房,辽宁沈阳110000 [5]中国医科大学附属盛京医院第二普通外科胆道、整形美容外科病房,辽宁沈阳110000

出　　处：《中华医院感染学杂志》2023年第14期2138-2142,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2019J0211)。

摘　　要：目的探究结直肠癌术后切口感染患者分离产β-内酰胺酶(ESBLs)大肠埃希菌的耐药性及分子分型。方法收集2018年5月-2021年5月于中国医科大学附属盛京医院进行手术治疗的结直肠癌患者术后切口感染分泌物分离出的大肠埃希菌105株,筛选产ESBLs大肠埃希菌菌株48株,采用纸片扩散(K-B)法进行药敏试验,采用聚合酶链式反应(PCR)扩增鉴定产ESBLs大肠埃希菌β-内酰胺酶基因型,采用多位点序列分型(MLST)分析产ESBLs大肠埃希菌ST分型。结果48株产ESBLs大肠埃希菌对碳青霉烯类抗菌药物完全敏感,对阿米卡星、妥布霉素耐药率分别为18.75%和25.00%,但对其他抗菌药物耐药率均较高,表现为多重耐药;产ESBLs大肠埃希菌对常用抗菌药物(阿米卡星、妥布霉素、亚胺培南和美罗培南除外)的耐药率高于非产ESBLs大肠埃希菌(P<0.05);48株产ESBLs大肠埃希菌均检出β-内酰胺酶基因,其中31株(64.58%)检出携带TEM-1基因,19株(39.58%)检出携带CTX-M-14基因;48株产ESBLs大肠埃希菌共有10种ST分型,以ST131(31.25%)为主。结论结直肠癌术后切口感染患者分离产ESBLs大肠埃希菌表现为多重耐药,对多种抗菌药物存在不同程度耐药,产ESBLs大肠埃希菌以TEM-1、CTX-M-14为主要基因型,主要ST分型为ST131型。OBJECTIVE To explore the drug resistance and molecular types of extended-spectrumβ-lactamases(ESBLs)-producing Escherichia coli strains isolated from colorectal cancer patients with postoperative incision infection.METHODS Totally 105strains of E.coli were isolated from postoperative incision infection secretions of the colorectal cancer patients who received surgical procedures in Shengjing Hospital of China Medical University from May 2018to May 2021,and 48strains of ESBLs-producing E.coli were screened out.Drug susceptibility testing was performed by using disk diffusion(K-B)method,the genotypes ofβ-lactamases in the ESBLs-producing E.coli strains were identified by polymerase chain reaction(PCR),and ST types of the ESBLs-producing E.coli strains were analyzed by means of multilocus sequence typing(MLST).RESULTS All of the 48strains of ESBLsproducing E.coli were sensitive to carbapenems,and the drug resistance rates to amikacin and tobramycin were 18.75%and 25.00%,respectively,however,the strains were highly resistant to other antibiotics and showed multi-drug resistance.The drug resistance rates of the ESBLs-producing E.coli strains to the commonly used antibiotics(except for amikacin,tobramycin,imipenem and meropenem)were significantly higher than those of the non-ESBLs-producing E.coli strains(P<0.05).All of the 48strains of ESBLs-producing E.coli were detected withβ-lactamase gene,31(64.58%)carried with TEM-1gene,19(39.58%)carried with CTX-M-14gene.The 48strains of ESBLs-producing E.coli had 10ST types,31.25%of which were ST131.CONCLUSIONThe ESBLsproducing E.coli strains that are isolated from the colorectal cancer patients with postoperative incision infection are multidrug-resistant and show various degrees of resistance to multiple antibiotics.TEM-1and CTX-M-14are the major genotypes among the ESBLs-producing E.coli,and ST131is the predominant ST type.

关 键 词：结直肠癌 切口感染 产β-内酰胺酶大肠埃希菌 耐药性 基因 分型 

分 类 号：R735.3[医药卫生—肿瘤]