摘要
目的研究胆道感染产ESBLs大肠埃希菌耐药和流行情况。方法选取2009—2013年南阳地区和昆明地区分离自胆道感染患者产ESBLs大肠埃希菌182株,采用最低抑菌浓度法做药敏试验,采用PCR扩增分离株13种耐药基因并对产物进行溴化乙锭染色和凝胶成像。结果产ESBLs大肠埃希菌对哌拉西林、头孢噻肟、头孢曲松3种药物耐药率均在80%以上,对氟喹诺酮类药物中的环丙沙星和左氧氟沙星耐药率分别为47.25%和56.04%,对头霉素类抗生素头孢西丁耐药率为21.43%,对碳青霉烯类抗生素美罗培南和亚胺培南全部敏感。PCR扩增产ESBLs大肠埃希菌分离株耐药基因,有97株检出TEM基因,占53.30%;52株检出SHV基因,占28.57%;21株检出CTX-M-1基因,占11.54%;3株检出CTX-M-2基因占,1.65%;5株检出到CTX-M-3基因,占2.75%;1株检出CTX-M-8基因,占0.55%;47株检出CTX-M-9基因,占25.82%;32株检出CTX-M-14基因,占17.58%;29株检出OTA-1基因,11株检出OTA-10基因,分别占15.93%和6.04%。未检出CTX-M-5和OTA-2基因。结论胆道感染产ESBLs大肠埃希菌耐药基因亚型呈多样化,与近年来人员流动较大有关,哌拉西林、头孢噻肟、头孢曲松不能用于治疗产ESBLs大肠埃希菌感染,碳青霉烯类抗生素可以作为一线药物用于治疗产ESBLs大肠埃希菌严重感染。
Objective To study the antibiotic resistance and the prevalence of Escherichia coli in biliary tract infections. Methods One hundred and eighty-two strains of E.coli were isolated from patients with a biliary tract infection in Nan Yang and Kun Ming from June 2009 to Dec 2013.The drug sensitivity of the 182 strains of extended-spectrum beta-lactamase（ESBL）-producing E.coli strains to 12 antibiotics was tested to determine the minimum inhibitory concentration.Drug resistance genes from 13 isolates of ESBL-producing E.coli strains were amplified using PCR,and the products were stained with ethidium-bromide（EB）and imaged using gel electrophoresis. Results Resistance of ESBL-producing E.coli to PIP,CTX,and CRO was over 80%,resistance to the fluoroquinolones CIP and LEV was 47.04% and56.04%,resistance to the cephamycin FOX was 21.43% and resistance to the carbapenems IMP and MER was 0%.Drug resistance genes were amplified from the 13 isolates of ESBL-producing E.coli strains.Ninety-seven strains had a TEM gene（53.30%）,52 had an SHV gene（28.57%）,21 had CTX-M-1（11.54%）,3had CTX-M-2（1.65%）,5had CTX-M-3（2.75%）,1had CTX-M-8（0.55%）,47 had CTX-M-9（25.82%）,32 had CTX-M-14（17.58%）,29 had OTA-1,and 11 had OTA-10.None of the strains had CTX-M-5or OTA-2. Conclusion In recent years,the subtype of drug resistance genes has diversified,and this diversity is related to the large migrant population.Piperacillin,cefotaxime,and ceftriaxone cannot be used to clinically treat patients infected with ESBL-producing E.coli,and carbapenem antibiotics can be used as a first-line drug for the treatment of severe infection with ESBL-producing E.coli.
出处
《中国病原生物学杂志》
CSCD
北大核心
2014年第12期1126-1129,共4页
Journal of Pathogen Biology
关键词
产ESBLS大肠埃希菌
药敏试验
耐药基因
ESBL-producing Escherichia coli
drug sensitivity test
drug resistance genes
