呼吸道肺炎克雷伯菌耐药性与CTX-M型ESBLs的研究

Study on the resistance of klebsiella pneumoniae which come from respiratory tract and CTX-M ESBLs

目的探讨来源于呼吸道肺炎克雷伯菌(KP)耐药性与CTX-M型超广谱β-内酰胺酶(ESBLs)的关系。方法采用PCR扩增和测序分析检测KP质粒和染色体上的CTX-M型ESBLs基因;采用纸片扩散法检测抗菌药物敏感性;使用χ2检验分析相关数据。结果有CTX-M-1群酶和CTX-M-25群酶检出,CTX-M型ESBLs的总检出率为39.02%(48株),其中质粒和染色体上同时携带CTX-M-1群酶的检出率为26.02%(32株)。β-内酰胺类抗菌药物头孢唑林、氟喹诺酮类抗菌药物左旋氧氟沙星、磺胺类抗菌药物复方磺胺甲恶唑等在CTX-M型ESBLs阳性组的耐药率明显高于阴性组(P<0.05)。结论在来源于呼吸道的KP中,在质粒和染色体上同时携带CTX-M-1群酶基因最常见,CTX-M型ESBLs与KP对某些抗菌药物产生耐药性关系密切。

Objective To investigate the relationship between the resistance of klebsiella pneumoniae（KP）which come from respiratory tract and CTX-M extended spectrumβ-lactamase（ESBLs）.Methods Detecting CTX-M ESBLs genes in the plasmid and chromosomes were used by PCR and sequence analysis;Disk diffusion method was sued by antibiotics susceptibility test;Chi square test was sued by analytic the data.Results CTX-M-1ESBLs and CTX-M-25 ESBLs were detected in the KP and the total detection rate of CTX-M ESBLs was 39.02%（48strains）,the detection rate of CTX-M-1ESBLs was 26.02%（32strains）which existence in the plasmid and chromosomes simultaneously.The resistance rate ofβ-lactam antibiotic cefazolin,fluoroquinolone antibiotic levofloxacin and sulfonamides antibiotic bactrim and so on in positive group of CTX-M ESBLs were significantly higher than negative group of CTX-M ESBLs（P〈0.05）.Conclusion CTX-M-1ESBLs gene which concurrent in the plasmid and chromosomes may the most common.KP resistance to certain antibiotics closely is relate to the CTX-M ESBLs.