新生儿产ESBLs肺炎克雷伯菌耐药性和基因型分析研究

Antibiotic resistance and genotypes of extended spectrum β-lactamases producing Klebsiella pneumoniae isolates from infants

目的:分析了解新疆地区新生儿科分离的产超广谱β-内酰胺酶(Extended-Spectrumβ-lactamase,ESBLs)肺炎克雷伯菌的耐药性及耐药基因分布情况。方法:采用K-B法测定病原菌对19种抗菌药物的耐药率,采用聚合酶链反应(PCR)检测TEM、SHV、CTXM-1、CTXM-9等4种β-内酰胺酶基因,并对部分产物进行测序分析。结果:100株产ESBLs菌对亚胺培南全部敏感,对喹诺酮类耐药率在10%以下;但对大多β-内酰胺类抗生素全部耐药。基因型分析显示有72株携带TEM基因,79株携带SHV基因,58株携带CTX-M-1基因,42株携带CTX-M-9基因;91%的菌株同时携带两种及两种以上ESBLs基因型。结论:新生儿产ESBLs的肺炎克雷伯菌耐药严重,新疆地区新生儿以同时携带多种ESBLs基因型为主。

Objective：To investigate the distribution of genotype and antibiotic resistance of extended spectrum β-lactamases（ESBLs）-producing Klebsiella pneumoniae isolated from infants in Xinjiang.Methods：Disk diffusion test（Kirby-Bauer） was used for determination of anti-microbial susceptibility.Genes including TEM,SHV,CTXM-1,CTXM-9 were detected by polymerase chain reaction（PCR） and some positive products were sequenced.Results：100 strains ESBLs were all sensitive to imipenem.Rsistance of fluoroquinolones was below 10%.Most of other antibiotics were all resistant.Genotype showed that 72 strains carry TEM,79 strains carry SHV,58 strains carry CTX-M-1 and 42 strains with CTX-M-9.Both and above both sort of genotypes were carried by 91% ESBLs producing strains.Conclusion：Antibiotic resistance of ESBLs-producing Klebsiella pneumoniaeisolates from infants in Xinjiang is very serious,multi-genotypes exist simultaneously in ESBLs from infants.