【摘要】 目的了解山东中医药大学附属医院分离的大肠埃希菌中产超广谱β内酰胺酶(ESBLs)菌株的耐药特征及CTX-M型、TEM型、SHV型基因流行状况。方法采用双纸片法检测ESBLs,聚合酶链反应(PCR)检测CTX-M酶、TEM酶、SHV酶基因型DNA序列分析确认TEM及SHV基因亚型,K-B法进行药敏试验。结果 83株大肠埃希菌中45株ESBLs表型确证试验阳性,检出率为54.2%,PCR扩增结果显示83株大肠埃希菌中CTX-M型基因扩增阳性44株(53.0%),TEM型阳性32株(38.6%),SHV型阳性1株(1.2%),TEM型和SHV型测序结果分别为TEM-1亚型和SHV-1亚型。产ESBLs大肠埃希菌,除对亚胺培南、美罗培南未见耐药外,对阿米卡星、哌拉西林-他唑巴坦和头孢西丁耐药性较低,耐药率分别为13.3%、17.8%和31.1%,产ESBLs大肠埃希菌,除了对头孢菌素、单环β内酰胺类抗生素具有很高耐药性外,对甲氧苄啶-磺胺甲噁唑、左氧氟沙星、环丙沙星和庆大霉素具有较高耐药性,耐药率均高于60%。结论该院产ESBLs大肠埃希菌基因型以CTX-M型为主。产ESBLs大肠埃希菌呈现多重耐药趋势。更多还原

【Abstract】 Objective To detetct the production of extended spectrum β-lactamases(ESBLs) and the prevalence of CTX-M type,TEM-,SHV gene in E.coli.Methods Double-disk test and phenotypic confirmatory test were used to detect ESBLs in the E.coli strains isolated from clinical specimens.Polymerase chain reaction(PCR) was applied to identify CTX-M,TEM and SHV genotype.DNA sequence analysis was utilized to confirm the TEM and SHV gene subtypes.Results The overall prevalence of ESBLs-producing strains in E.coli isolates was 54.2%(45/83).CTX-M-type ESBLs was produced in 44 of 83 isolates(53.0%),TEM type ESBLs in 32 of 83 isolates(38.6%).and SHV type ESBLs in only 1 isolates(1.2%).No imipenem - or meropenem-resistant strain was found.The ESBLs-producing strains showed lower resistance to amikacin,piperacillin -tazobactam.cefepime.About 13.3%,17.8%,31.1%of the strains were resistant to these antibiotics,respective.y.More than 60%of the ESBLs-producing strains were resistant to trimethoprim-sulfamethoxazole,ievofloxacin,ciprofloxacin or gentamicin. Conclusions CTX-M group was the main ESBLs genotype.ESBLs-producing E.coli are usually multiple drug resistant.更多还原