摘要
目的探讨产超广谱β-内酰胺酶大肠埃希菌blaCTX-M基因分型及相应耐药特征,以指导临床抗菌药物的合理应用。方法选取2014年1月到2016年1月医院细菌室分离出的大肠埃希菌69株;对上述菌株进行产超广谱β-内酰胺酶表型及耐药特征的检测;统计产超广谱β-内酰胺酶大肠埃希菌检出率及其基因型的分布;对比不同基因型的产超广谱β-内酰胺酶大肠埃希菌的耐药率。结果 69株菌株中,37株为产超广谱β-内酰胺酶大肠埃希菌,其中36株为blaCTX-M型基因,占97.30%;单独检出blaCTX-M-1有10株,占27.78%,单独检出blaCTX-M-9有24株,占66.67%,同时检出blaCTX-M-1和blaCTX-M-9有2株,占5.56%。CTX-M-1菌株和CTX-M-9菌株对亚胺培南的耐药率均为0,对头孢噻肟、头孢曲松、头孢唑林的耐药率均为100%。CTX-M-1菌株对头孢他啶、头孢吡肟、氨曲南的耐药率均显著高于CTX-M-9菌株(P<0.05)。结论 blaCTX-M是产超广谱β-内酰胺酶大肠埃希菌最常见的基因型,且以blaCTX-M-9型为主。blaCTX-M-1型菌株对头孢他啶、头孢吡肟以及氨曲南的耐药性显著高于blaCTX-M-9型菌株。
OBJECTIVE To explore the BlaCTX-M genotypes of extended-spectrum β-lactamases （ESBLs）-produ- cing Escherichia coli and observe the characteristics of drug resistance so as to provide guidance for reasonable clinical use of antibiotics. METIIODS A total of 69 strains of E. coli were isolated in bacteriology rooms from Jan 2014 to Jan 2016. The phenotypes of ESBLs of the above strains were detected, the characteristics of drug resist- ance were observed, the isolation rate of ESBLs-producing E. coli and distribution of genotypes were statistically analyzed, and the drug resistance rate was compared among the different genotypes of ESBLs-producing E. coli strains. RESULTS Of the 69 strains of E. coli, 37 were ESBLs-producing E. coli, of which 36 （97.30%） carried with BlaCTX-M gene; there were 10 （27.78%） strains detected positive for single BlaCTX-M-1 , 24 （66.67%） strains detected positive for single blaCTX-M-9, and 2 （5.56%） strains detected positive for both blaCTX-M-1 and blaCTX-M-9. The drug resistance rates of the E. coli strains carrying with CTX-M-1 and CTX-M-9 to imipen- em were O~ the drug resistance rates to cefotaxime, ceftriaxone, and cefazolin were 100%. The drug resistance rates of the E. coli strains carrying with CTX-M-1 were significantly higher than those of the E. coli strains carry- ing with CTX-M-9 （P〈0.05）. CONCLUSION The blaCTX-M is the most common genotype in the ESBLs-producing E. coli strains, among which the blaCTX-M-9 is dominant. The drug resistance rates of the strains carrying with blaCTX-M-1 to ceftazidime, cefepime, and aztreonam are significantly higher than those carrying with blaCTX-M- 9.
作者
孙文萱
田鹏飞
李轶
刘玲
王洪新
SUN Wen-xuan TIAN Peng-fei LI Yi LIU Ling WANG Hong-xin(Xinxiang Central Hospital, Xinxiang, Henan 453000, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第5期972-975,共4页
Chinese Journal of Nosocomiology
基金
河南省科技厅基础科技攻关基金资助项目(123400721142)
