【摘要】 目的了解引起医院感染的阴沟肠杆菌临床菌株ESBLs的分布及流行情况,为控制ESBLs流行提供依据。方法连续收集了27株不重复的对头孢他啶或头孢噻肟耐药的阴沟肠杆菌临床菌株,采用系列ESBLs特异性引物进行PCR,并对PCR产物测序;同时采用ERIC2引物进行rep-PCR。结果对头孢他啶或头孢噻肟耐药的阴沟肠杆菌临床菌株中最为流行的ESBLs是CTX-M-3样(13株阳性,占48%);在我国首次发现肠杆菌科细菌中有VEB-1样β-内酰胺酶流行;产ESBLs阴沟肠杆菌大多具有克隆相关性,它们在流行过程中又分别获得了不同的ESBLs耐药基因。结论上海华山医院引起医院感染的阴沟肠杆菌ESBLs产生率高,是阴沟肠杆菌对β-内酰胺类药物耐药的重要原因。更多还原

【Abstract】 OBJECTIVE To understand the distribution and epidemiology of ESBLs in ceftazidime or cefotaxime-(resistant) clinical Enterobacter cloacae isolates.METHODS Twenty seven ceftazidime or cefotaxime-resistant(nonrepetitive) E.cloacae were collected from 27 patients hospitalized at the Huashan Hospital,Shanghai.PCR and(sequencing) were performed to understand the distribution of ESBLs in E.cloacae;rep-PCR was(performed) to(understand) the epidemiology of ESBLs in E.cloacae.RESULTS CTX-M-3 like(ESBLs) were the most prevalent in our study(48%);this was the first report of VEB-1-like ESBLs in the member of(Enterobacteriaceae) in China,and the first report of the ESBLs VEB-1-like and CTX-M-3-like in an isolate simultaneously;the majority of(ESBLs) producers exhibited the same rep-PCR pattern,but harbored different ESBLs gene.(CONCLUSIONS) In our study,ESBLs have become prevalent in clinical E.cloacae isolates,and become an important factor of E.cloacae isolates resistant to extended-spectrum beta(-lactams).更多还原