【摘要】 目的了解某地区肿瘤患者医院感染产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的基因型及耐药性。方法用CLSI推荐的双纸片扩散法表型确证试验确定临床标本中产ESBLs大肠埃希菌251株,随机抽取其中50株应用聚合酶链反应(PCR)方法分别扩增产ESBLs大肠埃希菌常见的β-内酰胺酶基因:TEM、SHV和CTX-M;微量稀释法测定产与非产ESBLs菌株对18种抗菌药物的耐药率并进行比较。结果 PCR扩增显示,50株产ESBLs大肠埃希菌中,TEM 48株(96.00%)、CTX-M1 36株(72.00%)、CTX-M13 36株(72.00%)和SHV 20株(40.00%);45株(90.00%)携带2种或2种以上耐药基因。微量稀释法测定产与非产ESBLs大肠埃希菌对亚胺培南及美罗培南的耐药率均为0,但产ESBLs大肠埃希菌的耐药率除哌拉西林/他唑巴坦、阿莫西林/克拉维酸以外的其余14种抗菌药物均高于非产ESBLs菌株,多种抗菌药物两者差异均有统计学意义(P<0.05)。结论该地区肿瘤患者医院感染产ESBLs大肠埃希菌基因型以TEM、CTX-M1、CTX-M13型为主。产ESBLs大肠埃希菌呈现多重耐药趋势。更多还原

【Abstract】 Objective The aim of this study was to investigate the genotypes and drug resistance of ESBLs-producing Escherichia coli hospital infection in cancer patients in this area. Methods 251 ESBL isolates were determined from the clinical specimens by Kirby-Bauer disc diffusion method recommended by CLSI and then 50 were randomly selected to increase the common β-lactamase genes such as TEM, SHV and CTX-M in ESBLs-producing Escherichia coli by polymerase chain reaction(PCR). Drug resistance rate and their comparison were made to test if the ESBLs strains were produced or not in 18 kinds of anti-bacterials by microdilution test. Results The results of PCR amplification showed that genes of TEM 48 strains(96.0%), CTX-M1 36 strains(72.0%), CTX-M13 36 strains(72.0%) and SHV 20 strains(40.0%)were positive in 50 strains. ESBLs-producing coli showed that 45 strains(90.0%) carry two or more drug resistance genes.Microdilution method determined that the ESBLs producing and non producing Escherichia coli resistant to imipenem and meropenem, but the resistance rate of ESBLs producing Escherichia coli was zero. In addition, the piperacillin/tazobactam,amoxicillin/clavulanic acid and the other 14 kinds of antibiotics were higher than that of non ESBLs producing strains, the antibacterial of two drugs had statistically significant difference(P <0.05). Conclusion The genotypes of ESBLs-producing Escherichia coli hospital infection in this area were mainly TEM, CTX-M1 and CTX-M13 and the ESBLs-Producing Escherichia coli here had a tendency to be multi-drug resistance.更多还原