肝硬化并发自发性腹膜炎腹水中大肠埃希菌耐药性和基因型分布的研究

Antibiotic Resistance and Genotype of Escherichia coli in Liver Cirrhosis Patients Combined with Spontaneous Bacterial Peritonitis

目的了解肝硬化并发自发性腹膜炎腹水中大肠埃希菌的耐药性和产超广谱β-内酰胺酶(ESBLs)菌基因型分布状况。方法采用纸片扩散法(K-B法)对大肠埃希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56株大肠埃希菌共检出产ESBLs菌20株,产酶率为35.7%,对亚胺培南、美罗培南和头孢哌酮/舒巴坦全部敏感,产ESBLs株对其他抗菌药敏感性较低;在20株产ESBLs菌中有12株产TEM型酶,3株SHV型酶,10株产CTX-M型酶和2株产OXA型酶。结论肝硬化并发自发性腹膜炎腹水中大肠埃希菌耐药严重,TEM和CTX-M型基因多见。

OBJECTIVE To investigate the drug resistance of Escherichia coli and genotype of ESBLs in liver cirrhosis patients combined with spontaneous bacterial peritonitis（SBP）. METHODS Antimicrobial susceptibility testing was performed using Kirby-Bauer method. The genotypes of ESBLs were detected by PCR. RESULTS The detection rate of ESBLs-producing bacteria was 35.7% （20 strains）. The drug-sensitivity test indicated that E. coli was sensitive to imipenem,meropenem and cefoperazone/subactam. These ESBLs-producing strains were relatively resistant to other antimicrobial agents. ESBLs were identified as TEM type in 12 strains, SHV type in 3 strains, CTX-M type in 10 strains and OXA type in 2 strains. CONCLUSIONS ESBLs-Producing E. coli in liver cirrhosis patients combined with SBP have highly-resistances. TEM and CTX-M was the most common ESBLs genotypes.