【摘要】 目的研究大肠埃希菌(Escherichiacoli)和肺炎克雷伯菌(Klebsiella peumoniae)临床分离株耐药性及其质粒谱变化。方法对福建医科大学2所附属医院分离的E.coli和K.peumoniae共53株行药敏试验,检出产超广谱β-内酰胺酶(ESBLs)的菌株用碱变性法提取质粒,采用0.8%琼脂糖凝胶电泳分析质粒谱。结果产ESBLs菌株对多数青霉素和头孢菌素类抗生素耐药,对碳青霉烯类和酶抑制剂敏感(P<0.05)。不产ESBLsE.coli菌对喹诺酮类的敏感性高于产酶菌株(P<0.01)。受检菌株对丁胺卡那霉素的敏感性较高。产ESBLs菌株60.0%检出质粒,其中50%携带0.9 kb质粒。对环丙沙星耐药的E.coli,50%携带4.2 kb质粒;4株对丁胺卡那霉素耐药的E.coli中,2株携带9.4kb质粒。结论E.coli和K.peumoniae产ESBLs主要由质粒介导。0.9 kb质粒可能与产ESBLs有关;4.2 kb的质粒可能与环丙沙星耐药有关;9.4 kb质粒可能与丁胺卡那霉素耐药有关。更多还原

【Abstract】 Objective To investigate changes in the antibiotic resistance and plasmid profile of Escherichia coli and Klebsiella pneumoniae isolated from clinical specimens.Methods A total of 53 strains of E.coli and K.pneumoniae were isolated from two hospitals affiliated with Fujian Medical University.Antimicrobial susceptibility testing was done by the Kirby-Bauer method,and the antibiotic plasmid profile of extended-spectrum β-lactamase(ESBL)-producing strains was analyzed by alkaline denaturation and 0.8% agarose gel electrophoresis.Results ESBLs-producing strains were resistant to most penicillins and cephalosporins and susceptible to a combination of carbapenems and β-lactamase inhibitors(P<0.05).The susceptibility to quinolones of non-ESBLs-producing E.coli strains was markedly higher than that of strains producing ESBLs(P<0.01).The tested strains were susceptible to amikacin sulfate.A plasmid was detected in 60.0% of the ESBLs-producing strains,and 50% of these were the 0.9 kb plasmid.A plasmid was detected in the E.coli strains resistant to Ciprofloxacin,and 50% of these were the 4.2 kb plasmid.The 9.4 kb plasmid was detected in 2 of 4 E.coli strains resistant to amikacin sulfate.Conclusion ESBLs produced by E.coli and K.pneumoniae are mainly plasmid-mediated,and the 0.9 kb plasmid is closely related to ESBLs-production.The 4.2 kb plasmid may be resistant to ciprofloxacin.The 9.4 kb plasmid may be resistant to amikacin sulfate.更多还原