摘要
目的研究呼吸道感染产超广谱β-内酰胺酶(ESBLs)细菌的耐药性及基因分型,以期为临床诊治提供一定的参考。方法选取2011年1月-2013年6月临床分离的呼吸道感染产ESBLs细菌,应用纸片扩散法检测其对常用抗菌药物的耐药性,并应用聚合酶链式反应(PCR)法分析细菌基因分型。结果经痰液、肺部分泌物培养及咽拭子分离得到不重复大肠埃希菌54株、肺炎克雷伯菌50株,其中产ESBLs大肠埃希菌28株检出率51.9%,产ESBLs肺炎克雷伯菌26株检出率52.0%;产ESBLs菌对头孢类抗菌药物的耐药率较高,其中对头孢他啶、头孢曲松、头孢呋辛的耐药率均为100.0%;对β-内酰胺类抗菌药物/酶抑制剂符合耐药率的抗菌药物为氨苄西林/舒巴坦、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦,且对亚胺培南、美罗培南的耐药率均为0,上述比较差异均有统计学意义(P<0.05);产ESBLs菌中检出TEM型基因16株、SHV型基因6株、CTX-M-1型基因11株、CTX-M-9型基因20株,分别占29.6%、11.11%、20.4%、37.0%。结论产ESBLs细菌具有多药耐药性,经PCR扩增后可见以质粒介导的多药耐药基因表达符合其多药耐药表型。
OBJECTIVE To study the drug resistance and genotypes of the extended‐spectrum β‐lactamases （ES‐BLs）‐producing bacteria causing respiratory tract infections so as to provide guidance for clinical diagnosis and treatment .METHODS From Jan 2011 to Jun 2013 ,the clinical isolates of ESBLs‐producing bacteria causing respir‐atory tract infections were included in the study ,then the drug resistance of the strains to the commonly used anti‐biotics was tested by using disk diffusion method ,and the genotyping of the strains was performed with the use of polymerase‐chain‐reaction （PCR） .RESULTS Totally 54 strains of non‐repetitive Escherichia coli and 50 strains of K lebsiella pneumoniae were cultured from the sputum ,lung secretions ,and throat swabs ;the isolation rate of the ESBLs‐producing E .coli was 51 .9% （28 strains） ,and the isolation rate of the ESBLs‐producing K .pneumoniae was 52 .0% （26 strains） .The ESBLs‐producing strains were highly resistant to cephalosporins ,the drug resist‐ance rates to ceftazidime ,ceftriaxone ,and cefuroxime were 100 .0% ,the drug resistance rates to the compounds of β‐lactams and enzyme inhibitors such as ampicillin‐sulbactam ,cefoperazone‐sulbactam ,and piperacillin‐tazobac‐tam as well as imipenem and meropenem were 0 ,there was significant difference （P〈0 .05） .The TEM genotype was detected positive in 16 （29 .6% ） strains of ESBLs‐producing bacteria ,SHV genotype in 6 （11 .11% ） strains , CTX‐M‐1 genotype in 11 （20 .4% ） strains ,CTX‐M‐9 genotype in 20 （37 .0% ） strains .CONCLUSION The ES‐BLs‐producing bacteria are multidrug‐resistant ,and the PCR amplification reveals that the plasmid‐mediated ex‐pression of the multidrug‐resistant genes is consistent with the multidrug‐resistant phenotypes .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第5期978-980,共3页
Chinese Journal of Nosocomiology
基金
河南省卫生厅科技攻关基金资助项目(201303091)
关键词
呼吸道
超广谱Β-内酰胺酶
细菌
耐药性
基因型
Respiratory tract
Extended-spectrum β-lactamase
Bacteria
Drug resistance
Genotype
