厦门地区儿科患者分离的产超广谱β-内酰胺酶大肠埃希菌耐药及基因型分析

Analysis on Drug Resistance and Genotypes of Escherichia coli Producing Extended Spectrum-beta-lactamase Isolated from Pediatric Patients in Xiamen Area

目的了解厦门地区儿科患者分离的产超广谱β-内酰胺酶(ESBLs)大肠埃希菌耐药及基因型情况,为临床防治提供对策。方法分析2011年1-12月解放军第174医院儿科住院患者中分离的产ESBLs大肠埃希菌的耐药情况,并采用特定引物PCR扩增的方法进行ESBLs基因亚型分析。结果 2011年全年共分离产ESBLs的大肠埃希菌189株,阳性率为19.73%(189/958),药敏结果显示除碳氢酶烯类抗生素、加酶抑制剂复合抗生素类、头霉素类抗生素等不同程度敏感外,其余抗生素均耐药;基因亚型主要为CTX-M-13,还有TEM型。结论厦门地区儿童患者产ES-BLs情况较为严重,应尽量避免不适当地应用三代头孢菌素、长期预防应用抗生素等。一旦发生感染,应有针对性地选用碳青霉烯类和头霉素类等使感染得以控制。

Objective To investigate the drug resistance and genotypes of Escherichia coli producing extended spectrum -beta-lactarnase （ESBLs） isolated from pediatric patients in Xiamen area, and to provide the countermeasures for the clinical prevention and treatment. Methods The drug resistance of Escherichia coli producing ESBLs isolated from pediatric inpa- tients of the 174th Hospital of Chinese PLA from January to December 2011 was analyzed. PCR amplification with specific prim- ers was used to detect the genotypes of ESBLs. Results A total of 189 strains of Escherichia coli producing ESBLs were iso- lated in 2011, with the positive rate of 19.73% （189/958）. Drug sensitivity results showed that those strains were sensitive to carbapenem antibiotics, compound antibiotics of enzyme inhibitors and cephamycins antibiotics, but had varying degrees of resis- tance to other antibiotics tested. The gene subtypes of Escherichia coli producing ESBLs were mainly CTX- M- 13 and TEM. Conclusions The drug resistance of Escheri^hia coli producing ESBLs isolated from pediatric patients in Xiamen area was se- rious. Inappropriate application of the third generation cephalosporins and long- term preventive application of antibiotics should be avoided. Antibiotics like carbapenems and cephamycins should be used targetedly and timely in the patients with infections on the basis of the results of drug sensitivity.