产ESBLs大肠埃希菌和肺炎克雷伯菌耐药性和基因型分布

Antibiotic resistance and genotypes of extended-spectrum β-lactamases-producing Escherichia coli and Klebsiella pneumoniae

目的了解广州地区腹腔感染产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性及ESBLs基因型分布。方法采用纸片扩散法(K-B法)对大肠埃希菌和肺炎克雷伯菌进行抗菌药物的敏感性试验,通过PCR法分析其所产生基因型。结果产ESBLs菌株对亚胺培南全部敏感,对头孢哌酮-舒巴坦、头孢他啶和哌拉西林-三唑巴坦的敏感率为42.1%～76.3%,而对其他抗菌药物敏感率较低,对头孢噻肟的敏感率仅为0%～2.6%;基因型分析显示有35株产TEM型酶,14株产SHV型酶,29株产CTX-M型酶。结论腹腔感染产ESBLs的大肠埃希菌和肺炎克雷伯菌耐药严重,CTX-M型ESBLs多见。

Objective To investigate the drug resistance of Escherichia coli and Klebsiella pneumoniae producing extendedspectrum β-1actamases （ESBLs） in intraabdominal infections and analyze the genotypes of ESBLs, Methods Antimicrobial susceptibility testing was performed using Kirby-Bauer method. The genotypes of ESBLs were detected by PCR. Results The ESBLs-positive strains were 100.0%0 sensitive to imipenem, and about 42.1%-76.3% of the strains were sensitive to ceftazidime, cefoperazone-sulbactam, and piperacillin-tazobactam, These ESBLs-producing strains were relatively resistant to other antimicrobial agents. Cefotaxime was only active for about 0%-2.6% of the isolates. ESBL was identified as TEM type in 35 strains, SHV type in 14 strains, and CTX-M type in 29 strains. Conclusions ESBLs-producing E. coli and K. pneurnoniae in intraabdominal infections are highly-resistant. CTX-M is the most common ESBLs genotypes,