儿童患者中检出产ESBLs大肠埃希菌的耐药性和基因分型.docVIP

儿童患者中检出产ESBLs大肠埃希菌的耐药性和基因分型 【摘要】目的了解本地区儿童患者临床分离的产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的耐药基因型别和耐药性的变化情况。方法收集自儿童患者分离鉴定的大肠埃希菌株1 327株，通过K-B法作药敏试验,采用美国NCCLS1999年推荐的抑制剂增强纸片法确认产ESBLs株，并对ESBLs进行初步基因分型。结果检出产ESBLs菌株702株，检出率为52.9%，产ESBLs大肠埃希菌对青霉素类、氨曲南及头孢菌素类抗生素耐药率为55.5%～95.0%；PCR初步分型结果,单独携带TEM型基因的占56.7%，单独携带SHV型基因的占15.0%，携带两种基因的占25.8%。结论产ESBLs大肠埃希菌检出率逐年上升，具有多重耐药的特点；产ESBLs大肠埃希菌主要携带TEM型和SHV型β-内酰胺酶基因，其中绝大部分产TEM型β-内酰胺酶。 【关键词】 超广谱β-内酰胺酶(ESBLs) 大肠埃希菌 耐药性 基因分型 Analysis of drug resistance and gen typing of ESBLs-producing Escherichia coli isolated from infants. SHI Sheng, XIONG Yan. (Department of Clinical Laboratory, Jiangmen Municipal Peoplersquo;s Hospital, Jiangmen 529000, Guangdong, P.R.China) Abstract：Objective To investigate current resistant status and genetype of ESBLs-producing Escherichia coli in child patients. Methods There were 1 327 Escherichia coli strains isolated in clinic, and the ESBLs-producing isolates were identified by K-B method. The DNA of ESBLs-producing Escherichia coli were genetyped by polymerase chain reaction (PCR). Results There were 702 ESBLs-producing isolates with a positive rate of 52.9%. The resistant rates of ESBLs-producing Escherichia coli isolates to penicillins,aztreonam and the third generation cephalosporins were from 55.5% to 100%. The results of PCR showed that the rates of TEM type, SHV type and TEM with SHV type in ESBLs-producing Escherichia coli isolates were 56.7%,15.0% and 25.8%, respectively. Conclusion The incidence of ESBLs-producing Escherichia coli isolates was increased year by year, and they were multi-resistant. Most of the ESBLs-producing Escherichia coli isolates carry TEM related genes or/and SHV related genes, and the TEM related genes were the most. Key words：Extended spectrumbeta;-lactamases( ESBLs); Escherichia coli; Resistance; Gene typing 大肠埃希菌是临床常见的病原菌，也是医院感染的常见细菌之一。近年来，随着第三代头孢菌素的广泛使用，产超广谱beta;-内酰胺酶（Extended spectrumbeta;-lactamases, ESBLs）大肠埃希菌感染日益增多。ESBLs由质粒介导，易在同种属甚至不同种属细菌间传递造成暴发流行，给临床治疗带来许多困难。儿童患者由于免疫机能还不健全，抵抗力较低，是产ESBLs大肠