尿路感染大肠埃希菌产超广谱β-内酰胺酶的情况及耐药性  

Production of Extended-Spectrumβ-Lactamases by Escherichia Coli in Urinary Tract Infection and Its Drug Tolerance

作　　者：李琴 潘楚 刘琼 朱琪 周航 LI Qin;PAN Chu;LIU Qiong;ZHU Qi;ZHOU Hang(Department of Clinical Laboratory,the Third People's Hospital of Pingxiang City,Pingxiang 337000,China;不详)

机构地区：[1]萍乡市第三人民医院检验科,江西萍乡337000 [2]萍乡市第三人民医院泌尿外科,江西萍乡337000

出　　处：《中国医学创新》2025年第6期125-129,共5页Medical Innovation of China

基　　金：萍乡市科技计划项目(2023PY077)。

摘　　要：目的:分析尿路感染大肠埃希菌产超广谱β-内酰胺酶(ESBLs)的情况及耐药性。方法:纳入200株于尿路感染患者尿液样本中分离获得的大肠埃希菌菌株,尿路感染患者为萍乡市第三人民医院2023年1月-2024年1月收治。分析大肠埃希菌耐药性及产ESBLs大肠埃希菌基因型、ST分型情况。结果:200株大肠埃希菌鉴定分离出80株产ESBLs大肠埃希菌(40.00%),不产ESBLs大肠埃希菌120株(60.00%)。产ESBLs大肠埃希菌对头孢呋辛、头孢唑琳、氨苄西林完全耐药(耐药率均为100%),对诺氟沙星、复方新诺明、头孢噻肟、环丙沙星、左氧氟沙星、氨曲南、氨苄西林/他唑巴坦、头孢吡肟、头孢他啶严重耐药(耐药率分别为98.75%、95.00%、87.50%、85.00%、81.25%、78.75%、60.00%、58.75%、52.50%),对头孢哌酮/舒巴坦、阿米卡星、头孢西丁、磷霉素、呋喃妥因轻度耐药(耐药率为1.25%~41.25%),对亚胺培南、美罗培南完全敏感(耐药率均为0)。不产ESBLs大肠埃希菌对头孢哌酮/舒巴坦、氨苄西林、诺氟沙星严重耐药(耐药率分别为91.67%、78.33%、59.17%),对其他药物轻度耐药或不耐药(耐药率为0~39.17%)。80株产ESBLs大肠埃希菌均检出β-内酰胺酶基因,耐药基因型以TEM(68.75%)、CTM-M-14(61.25%)、CTX-M-15(37.50%)及SHV(32.50%)为主,其次为CTX-M-3(6.25%)、OXA(3.75%)。80株产ESBLs大肠埃希菌共检出5种主要ST分型,以ST131(31.25%)占比最高,其次为ST95(20.00%)、ST140(17.50%)、ST648(13.75%)、ST405(6.25%),其余未确定ST分型共9株,占11.25%。结论:尿路感染产ESBLs大肠埃希菌表现为多重耐药,对头孢呋辛、头孢唑琳、氨苄西林、诺氟沙星、复方新诺明等表现出较强耐药性,其基因型以TEM、CTM-M-14、CTX-M-15为主,其ST分型以ST131型为主。Objective:To analyze the production of extended-spectrumβ-lactamases(ESBLs)by Escherichia coli in urinary tract infection and its drug tolerance.Method:A total of 200 strains of Escherichia coli isolated from urine samples of patients with urinary tract infection were included.The patients with urinary tract infection were admitted to the Third People's Hospital of Pingxiang City from January 2023 to January 2024.The drug resistance of Escherichia coli,the genotypes and ST typing of ESBLs-producing Escherichia coli were analyzed.Result:Among the 200 strains of Escherichia coli,80 strains of ESBLs-producing Escherichia coli(40.00%)and 120 strains of non-ESBLs-producing Escherichia coli(60.00%)were identified and isolated.ESBLsproducing Escherichia coli were completely resistant to Cefuroxime,Cefazolin and Ampicillin(the drug resistance rate were 100%),and were severely resistant to Norfloxacin,Compound Sulfamethoxazole,Cefotaxime,Ciprofloxacin,Levofloxacin,Aztreonam,Ampicillin/Tazobactam,Cefepime and Ceftazidime(drug resistance rates were 98.75%,95.00%,87.50%,85.00%,81.25%,78.75%,60.00%,58.75%and 52.50%,respectively),and was mildly resistant to Cefoperazone/Sulbactam,Amikacin,Cefoxitin Fosfomycin and Nitrofurantoin(drug resistance rate was 1.25%-41.25%),and completely sensitive to Imipenem and Meropenem(drug resistance rates were 0).Non-ESBLsproducing Escherichia coli were severely resistant to Cefoperazone/Sulbactam,Ampicillin and Norfloxacin(drug resistance rates were 91.67%,78.33%,59.17%,respectively),and were mild or no resistance to other drugs(the drug resistarc rate was 0-39.17%).Theβ-lactamases genes were detected in 80 strains of ESBLs-producing Escherichia coli.The main drug resistant genotypes were TEM(68.75%),CTM-M-14(61.25%),CTX-M-15(37.50%)and SHV(32.50%),followed by CTX-M-3(6.25%)and OXA(3.75%).5 main ST types were detected in 80 strains of ESBLs-producing Escherichia coli,with ST131(31.25%)accounting for the highest proportion,followed by ST95(20.00%),ST140(17.50%),ST648(13.75%)and ST405(6.25%),a

关 键 词：尿路感染 大肠埃希菌 超广谱Β-内酰胺酶 耐药性 基因型 

分 类 号：R691.3[医药卫生—泌尿科学] R446.5[医药卫生—外科学]