沈阳地区儿科产超广谱β内酰胺酶革兰阴性菌的耐药性与基因型研究_药学论文.docVIP

沈阳地区儿科产超广谱β内酰胺酶革兰阴性菌的耐药性与基因型研究_药学论文 沈阳地区儿科产超广谱β内酰胺酶革兰阴性菌的耐药性与基因型研究_药学论文 【摘要】 目的 研究沈阳地区儿科产超广谱β内酰胺酶(extendedspectrum βlactamases，ESBLs)革兰阴性菌的耐药性及ESBLs基因型分布，初步探讨其多重耐药性传播的分子机制。方法 KB法药敏试验，按照CLSI/NCCLS 2005年标准筛选确认ESBLs表型，PCR法进行ESBLs基因型别分析，扩增I类整合子全可变区，分析产ESBLs菌株中整合子的存在情况。结果 在分离出的180株革兰阴性菌中，有62株经表型确证试验证实为产ESBLs菌株，检出率34.4%。产ESBLs菌株对各种抗菌药物的耐药率明显高于非产ESBLs菌株。基因分型结果表明，blaTEM基因阳性48株(77.4%)，blaSHV阳性32株(51.6%)，blaCTXM9组阳性31株(50%)，blaCTXM3组阳性12株(19.4%)。62株ESBLs菌株中26株整合子全可变区PCR扩增阳性，阳性率41.9%。结论 沈阳地区儿科革兰阴性菌中ESBLs菌株检出率较高，多数菌株同时携带两种或两种以上不同型别的β内酰胺酶，且为多重耐药菌株，整合子机制参与其多重耐药性的形成与传播。 【关键词】 革兰阴性菌； 超广谱β内酰胺酶； 耐药； 基因型； 整合子； 沈阳地区； 儿科 　　Investigation of antimicrobial resistance and genotypes of extendedspectrum　βlactamases producing Gramnegative bacteria isolated　from pediatrics in Shenyang 　　ABSTRACT Objective To study the antimicrobial resistance and genotypes of extendedspectrum βlactamases (ESBLs)producing Gramnegative bacteria isolated from pediatrics in Shenyang and preliminarily investigate the molecular mechanisms of their multiple antibiotic resistance dissemination process. Methods Antibiotics susceptibility was tested by KirbyBauer method. ESBLsproducing isolates were detected by phenotypic confirmatory test according to CLSI/NCCLS M100S15 (2005). The genotypes of ESBLs were analyzed by PCR, and the complete variable region of class 1 integron were amplified in order to analyze the presence and characterization of class 1 integron in ESBLs. Results Among a total of 180 Gramnegative isolates, 62 isolates were identified as ESBLs by phenotypic confirmatory test and the incidence was 34.4%. The ESBLsproducing isolates were more resistant to most antimicrobials than non ESBLsproducers. The results of βlactamases genotyping showed that 48 isolates carried blaTEM (77.4%)，32 isolates carried blaSHV (51.6%), 31 isolates carried blaCTXM9 (50%)and 12 isolates carried blaCTXM3 (19.4%). Class 1 integrons were identified among 26 isolates and the positive rate was 41.9%. C