妇科住院患者腹腔镜手术切口感染大肠埃希菌耐药性及耐药基因检测

Analysis of drug-resistant Escherichia coli infecting surgical sites in Gynecology inpatients after laparoscopic surgery and detection of drug resistance genes in Escherichia coli

目的分析妇科腹腔镜手术切口患者感染大肠埃希菌的耐药性及其与耐药基因的关系,为妇科患者抗感染治疗提供参考。方法从278例接受腹腔镜手术的妇科住院患者中分离大肠埃希菌206株,经鉴定后对菌株进行纯培养,采用K-B法进行耐药性分析;提取目的基因、设计引物,采用PCR检测大肠埃希菌的TEM、SHV、CTX-M-1、CX-M-9、qnr、qacE△1-sul1基因。结果药敏试验显示,分离株大肠埃希菌对哌拉西林、诺氟沙星、环丙沙星、头孢他啶、庆大霉素、头孢噻肟、氨曲南、妥布霉素、阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药率分别为84.95%、74.76%、69.90%、68.93%、64.56%、63.11%、31.55%、28.16%、13.59%、0.97%、0.49%和0。PCR检测大肠埃希菌的耐药基因大小分别为:TEM基因860bp,SHV基因928bp,CTX-M-1基因891bp,CX-M-9基因850bp,qnr基因240bp,qacE△1-sul1基因300bp,阳性率分别为64.56%、10.19%、37.86%、23.79%、7.77%和31.55%。结论妇科患者腹腔镜手术切口感染的大肠埃希菌临床分离株除对头孢哌酮/舒巴坦敏感外,对其他所选抗菌药物均耐药,耐药性的产生与其耐药基因的存在密切相关,检测耐药基因分布情况对于细菌的耐药性控制及妇科患者的临床治疗具有指导意义。

Objective The drug resistance of Escherichia co/i infecting Gynecology patients was analyzed and its drug resistance genes were detected to provide scientific evidence for treatment of infections in Gynecology patients. Methods Two hundred and six strains of E. coli were isolated from a total of 278 Gynecology patients who underwent laparoscopie surgery. After those strains were identified, pure cultures were OBtained and preserved. The drug resistance of E. coil was analyzed using the K-B method, and the results were judged according to the 2014 standards of the CLSL The TEM, SHV, CTX-M-1, CTX-M-9, qnr, and qacEAl%sull genes of E. coli were detected with PCR through target gene extrac- tion, primer design, gene amplification, and gel electrophoresis. Results Ana[ysis o{ drug resistance indicated that E. coli resistance to piperacillin was 84.95%, its resistance to norfloxacin was 74.76%, its resistance to eiprofloxacin was 69.90 %, its resistance to ceftazidime was 68.93%, its resistance to gentamycin was 64.56 %, its resistance to cefotaxime was 63.11 %, its resistance to aztreonam was 31.55 %, its resistance to tobramycin was 28.16 %, its resistance to amikacin was 13.59%, its resistance to imipenem was 0.97%, its resistance to meropenem was 0.49%, and its resistance to cefoperazone/sulbactam was 0. Thus, E. coli had not developed resistance to cefoperazone/sulbaetam. Results of PCR amplification indicated that TEM was 860 bp in length, SHV was 928 bp in length, CTX-M-1 was 891 hp in ength, CTX-M-9 was 850 bp in length, qnr was 240 bp in length, and qacEΔl-sull was 300 bp in length. PCR also indicated