皖江地区产ESBLs大肠埃希菌和肺炎克雷伯菌基因型及耐药性分析

Analysis of Genotypes and Antibiotic Resistance on ESBLs-producing Escherichia Coli and Klebsiella Pneumoniae in Anhui Province

目的研究安徽省芜湖及宿州两地临床产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率、基因型分布及对抗菌药物的耐药性。方法收集两地大肠埃希菌和肺炎克雷伯菌进行ESBLs确证试验;采用PCR法对产ESBLs株进行β内酰胺酶基因的扩增;微量稀释法测定产ESBLs株对13种抗菌药物的耐药率。结果两地大肠埃希菌和肺炎克雷伯菌ESBLs检出率的差异均无统计学意义(P>0.05),但基因型存在一定差异。bla(TEM)+bla(CTX-M-13)是最常见的基因检出模式。两地产ESBLs株对抗菌药物表现出不同的耐药率,但对亚胺培南和美洛培南均100%敏感。结论芜湖和宿州地区产ESBLs大肠埃希菌和肺炎克雷伯菌存在较严重的抗菌药物选择性压力;酶抑制剂复合制剂及碳青酶烯类是治疗产ESBLs大肠埃希菌和肺炎克雷伯菌感染的理想药物。

）Objective To study the detection rate,genotype and antibiotic resistance on clinical isolates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae in Wuhu and Suzhou,Anhui.Methods The confirmation test was used to detect ESB-producing bacteria strains.PCR method was used to amplify beta-lactamases of the isolates.And the MICs to 13 antimicrobials against ESBLs-producing E.coli and K.pneumoniae were determined by microdilution method.Results There was no statistical significance of differences for ESBLs-producing E.coli and K.pneumoniae detection between the two regions.The bla（TEM）＋bla（CTX-M-13） was the most common genotype.The drug resistance rates of ESBLs-producing bacteria differed in areas and all bacterias showed sensitivity to IMP and MER.Conclusions Antibiotic selection pressure was serious in ESBLs-producing E.coli and K.pneumoniae in the regions.The compounds of enzyme inhibitor and Carbapenems were ideal agents to treat infections of ESBLs-producing E.coli and K.pneumoniae.