多药耐药肠杆菌科细菌产超广谱β-内酰胺酶基因型研究

Research on Multi-drug Resistant Enterobacteriaceae Producing Extended Spectrum β-lactamase

目的研究医院感染产超广谱β-内酰胺酶(ESBLs)细菌的主要耐药基因型并进行序列分析。方法收集临床住院患者产ESBLs肺炎克雷伯菌、大肠埃希菌和变形菌属,通过改良Hodge试验、EDTA双纸片增效试验、分别测定KPC、金属酶;聚合酶链反应(PCR)检测其耐药基因、分析PCR产物序列并在GenBank中比对分析,总结产ESBLs细菌同源性的和变异情况。结果肺炎克雷伯菌中CTX型占85.0%,TEM型占77.0%,SHV型占15.0%;大肠埃希菌中3种基因型比较均衡,其中CTX占100.0%,SHV型和TEM型均为83.0%;变形菌属中TEM型占100.0%,CTX型占40.0%,未检出SHV型;同时还有携带金属酶和碳青酶烯酶的细菌检出。结论医院多药耐药肠杆菌科细菌产ESBLs耐药基因主要以CTX和TEM为主。

OBJECTIVE To study nosocomial main drug-resistant bacteria of genotype of the ultra-producing extended-spectrum β-lactamases （ESBLs） and sequence analysis. METHODS To collect clinical inpatients with the Klebsiella pneumoniae, Escherichia coli and Proteus producing ESBLs; through modified Hodge test and EDTA double disk synergy test, determine KPC, metal enzyme; polymerase chain reaction （PCR）to detect the resistance gene sequence analysis of PCR products and contrastively analyze the results in GenBank. At last, the t ESBLs producing bacterial homology and variation were summarized. RESULTS K. pneumoniae CTX-type accounted for 85.0%, TEM-type accounted for 77. 0%, SHV-type accounted for ]5. 0%; Proteus didnrt have SHV type, while the TEM-type accounted for 100. 0V0, CTX-type accounted for 40. 0%; the three kinds of genotypes of Colon coli bacteria were more balanced, in which CTX accounted for 100. 0% , SHV and TEM-type were 83.0%. CONCLUSIONS ESBLs-resistance gene of my nosocomial Enterobacteriaceae is mainly based on CTX and TEM.