摘要
目的对血流感染中分离的大肠埃希菌进行筛查并检测相关的耐药基因,为合理用药提供实验室依据。方法选取2015年6月至2016年5月温州医科大学附属第一医院门诊及住院患者血液中首次分离的216株大肠埃希菌,采用VITEK-2全自动微生物分析仪进行药敏试验;采用双纸片扩散法进行ESBLs表型检测;采用PCR方法筛选ESBLs基因,并测序确定其基因型。结果 216株大肠埃希菌对氨基糖苷类(除庆大霉素外)、头霉素类、呋喃妥因和碳青霉烯类等药物具有较好的敏感性,但对青霉素类、喹诺酮类和磺胺类药物耐药率较高;检出产ESBLs菌株56.94%(123/216);在130株第三代头孢菌素耐药株中,22株bla_(TEM)基因检测阳性,59株bla_(CTX-M)基因检测阳性,经测序比对显示:29株携带bla_(CTX-M-14)基因,23株携带bla_(CTX-M-15)基因。结论引起血流感染的大肠埃希菌多为对第三代头孢菌素耐药的产ESBLs菌株,携带的耐药基因主要为bla_(CTX-M)和bla_(TEM)。
Objective To analyze the drug resistance of Escherichia coli(E.coli) isolated from patients with bloodstream infections, and to provide evidence for the use of antibiotics. Methods A total of 216 E.coli strains isolated from patients with BSI in the First Affiliated Hospital of Wenzhou Medical University from June 2015 to May 2016 were selected.The identification and antimicrobial susceptibility testing of E.coli isolates were determined by VITEK-2 full automated microbiology analyzer.The double disk diffusion test was used for the determination of extended-spectrum β-lactamases(ESBLs) phenotype of E.coli isolates.ESBLs genes were screened by PCR and were sequenced for genotype. Results 216 E.coli isolates were all sensitive to aminoglycosides(except gentamicin), cephamycins, nitrofurantion and carbapenems, but were highly resistant to penicillins, quinolones and sulfonamides.123 of 216 E.coli isolates(56.94%) were found to produce ESBLs.Out of 130 strains resistant to the third-generation cephalosporins, 22 and 59 were positive for blaTEM and blaCTX-M determined by PCR, while 29 and 23 strains harbored blaCTX-M-14 and blaCTX-M-15 genes, respectively. Conclusions Majority of E.coli strains isolated from patients with BSI are ESBLs positive and highly resistant to the third-generation cephalosporins.blaCTX-M-14 and blaCTX-M-15 genes are approved to be closely related to the drug resistance of E.coli isolates.
作者
陈韩
郑周
陈思思
黄海霞
余方友
CHEN Han;ZHENG Zhou;CHEN Si-si;HUANG Hai-xia;YU Fang-you(Department of Laboratory,The First Affiliated Hospital of Wenzhou Medical University Wenzhou,Zhejiang 325000,China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第4期321-325,共5页
Chinese Preventive Medicine
基金
温州市公益性科技计划项目(Y20160499)
关键词
血流感染
大肠埃希菌
ESBLS
耐药基因
CTX-M
TEM
Bloodstream infection
Escherichia coli
Extended-spectrum β-lactamases
Drug resistance genes
CTX-M
TEM
