83株产ESBLs大肠埃希菌β-内酰胺酶耐药基因检测与药敏结果分析

Analysis of drug-resistance gene detection and drug sensitivity test results in 83 strains of ESBLs-producing escherichia coli

目的:了解产ESBLs大肠埃希菌耐药基因携带状况和菌株的耐药现状,以指导临床医师合理使用抗菌药物。方法:用K-B法测定自临床分离的83株产ESBLs大肠埃希菌对氨曲南等18种抗菌药物的敏感性,用PCR法检测TEM、SHV、CTX-M-1、CTX-M-3、CTX-M-9基因型分布情况。结果:83株大肠埃希菌中β-内酰胺酶基因TEM、SHV、CTX-M-1、CTX-M-3、CTX-M-9阳性率分别为85.5%、36.1%、22.9%、32.5%、13.3%,对丁胺卡那霉素、厄它培南、头孢替坦、亚胺培南完全敏感,对部分β-内酰胺类药物及含酶抑制剂药物的耐药率较高。结论:临床分离的产ESBLs大肠埃希菌TEM、SHV、CTX-M-1、CTX-M-3基因携带率较高,β-内酰胺类药物耐药率较高可能与细菌携带β-内酰胺酶耐药基因有关,临床应结合菌株的药物敏感试验选择最佳的抗菌药物。

Objective：To investigate the drug resistance status and antibiotic resistance genes of Eescherichia coli（E.coli） in order to provide references for the clinical application of antibiotics.Methods： Eighty-three strains of E.coli isolated from clinic were collected.Kirby-Bauer method was used to test antibiotic susceptibility for eighteen antibiotics,such as aztreonam.Polymerase chain reaction（PCR） was used to test the distribution of the antibiotic resistance gene TEM,SHV,CTX-M-1,CTX-M-3 and CTX-M-9.Results： Of Eighty-three E.coli strains,the positive rates of TEM,SHV,CTX-M-1,CTX-M-3,CTX-M-9 were 85.5%,36.1%,22.9%,32.5%,13.3%.All strains were susceptible to Amikacin,Ertapenem,Cefotetan,Imipenem.The resistant rate to a part of antibiotics containing β-lactamases or enzyme inhibitor was high.Conclusion： The ESBLs-producing strains isolated from clinic had high carrying rate of genes,such as TEM,SHV,CTX-M-1 and CTX-M-3.The high resistance rate of ESBLs-producing strains to β-lactam antibiotics may be related with antibiotic resistance genes.So the antibiotics used in clinical treatment should be combined the results of drug susceptibility test.