摘要
目的 分析某院分离的耐碳青霉烯类大肠埃希菌(CRECO)的耐药基因及同源性,为临床治疗及感控提供参考。方法 收集福建医科大学附属泉州第一医院2017-2021年分离的CRECO 36株,对成功复苏的15株CRECO进行耐药基因及同源性分析;用PCR扩增碳青霉烯酶(CPAs)基因(bla_(KPC)、bla_(IMP)、bla_(NDM)、bla_(VIM)、bla_(OXA-48));多位点序列分型(MLST)用于检测其基因序列(ST型)。结果 (1)36株CRECO标本类型主要为尿液(55.56%)。(2)CRECO对哌拉西林、左氧氟沙星等8种抗菌药物耐药率达100.0%,对庆大霉素、氯霉素等7种抗菌药物耐药率>50.0%,对阿米卡星、多黏菌素耐药率分别为19.4%、2.8%,尚未发现对替加环素耐药。(3)通过PCR扩增15株复苏菌株的耐药基因,共获得14株阳性:2株bla_(KPC-1),11株bla_(NDM-5),1株bla_(NDM-1);1株阴性。(4)MLST将11株携带bla_(NDM-5)的CRECO的ST型分为ST156、ST117、ST2177、ST744、ST405和ST10Cplx(复合群)。结论 CRECO呈多重耐药状态,对碳青霉烯类耐药与携带耐药基因bla_(NDM-5)密切相关,携带bla_(NDM-5)的CRECO以ST10Cplx流行为主。
Objective To analyze the drug resistance genes and homology of carbapenem-resistant Escherichia coli(CRECO)in a hospital to provide reference for clinical treatment and susceptibility control.Methods Clinical data of CRECO isolated from 2017-2021 in Quanzhou Frist Hospital Affiliated to Fujian Medical University were collected,and the resistance genes and homology of 15 successfully covered strains of CRECO were analyzed;carbapenemase(CPAs)genes(bla KPC,bla IMP,bla NDM,bla VIM,bla OXA-48)were amplified by PCR;multilocus sequence typing(MLST)was used to detect their gene sequences(ST type).Results(1)36 CRECO specimen type was mainly urine(55.56%).(2)The resistance rate of CRECO reached 100.0%for 8 antibiotics such as piperacillin and levofloxacin,>50%for 7 antibacterial drugs such as gentamicin and chloramphenicol,19.4%and 2.8%for amikacin and polymyxin,respectively,and no tymetracycline resistance was found yet.(3)Drug resistance genes in 15 recovered strains were amplified by PCR,and 14 positive strains were obtained:2 strains of bla KPC-1,11 strains of bla NDM-5,1 strain of bla NDM-1;the rest 1 strain was negative.(4)MLST classified the ST types of the 11 strains of CRECO carrying bla NDM-5 into ST156,ST117,ST2177,ST744,ST405 and ST10Cplx(complex group).Conclusion CRECO shows multi-drug resistance status,and resistance to carbapenems is closely related to carrying the resistance gene bla NDM-5,and carrying bla NDM-5 of CRECO is predominantly prevalent in ST10Cplx.
作者
宋瑞雅
闫小利
陈清清
林玉玲
SONG Ruiya;YAN Xiaoli;CHEN Qingqing;LIN Yuling(Department of Laboratory Medicine,Quanzhou Frist Hospital Affiliated to Fujian Medical University,Quanzhou,Fujian 362000,China)
出处
《检验医学与临床》
CAS
2023年第15期2206-2209,共4页
Laboratory Medicine and Clinic
基金
福建省泉州市科技局计划项目(2018Z052)。
关键词
大肠埃希菌
碳青霉烯酶
耐药基因
多位点序列分型
Escherichia coli
Carbapenemase
drug resistance gene
multilocus sequence type
