肺炎克雷伯菌ESBLs基因型分布与耐药相关性研究

Study on the Relationship Between ESBLs Genotype Distribution and Drug Resistance of Klebsiella Pneumoniae

目的研究聊城地区呼吸道感染患者中产ESBLs肺炎克雷伯菌相关耐药基因的分型及不同基因型与抗生素耐药性关系。方法收集2015年10-12月本院137例肺炎克雷伯菌阳性痰标本,比较分析基因型对抗生素的耐药性的关系。结果产ESBLs菌株对头孢他啶、头孢曲松、头孢噻肟、头孢吡肟和氨曲南的耐药率与非ESBLs菌株相比,差异有统计学意义（P〈0.05）;CTX-M型阳性菌株与阴性菌株相比,对抗生素头孢曲松、头孢噻肟和氨曲南耐药率差异有统计学意义（P〈0.05）;SHV型阳性菌株与阴性菌株相比,对抗生素头孢他啶和哌拉西林/他唑巴坦耐药率差异有统计学意义（P〈0.05）。结论通过检测肺炎克雷伯氏菌产ESBLs酶和ESBLs基因,分析ESBLs基因本院流行情况及常见基因与抗生素耐药关系,为指导临床医师合理用药提供可靠依据。

Objective To study the genotype and antibiotic resistance of ESBLs Klebsiella pneumoniae in patients with respiratory tract infections in Liaocheng area. Methods Collected 137 cases of Klebsiella pneumoniae positive sputum samples from October to December 2015 in our hospital, and analyzed the relationship between genotype and antibiotic resistance. Results The ESBLs producing strains to ceftazidime, ceftriaxone, cefotaxime, cefepime and aztreonam resistance rate compared with non ESBLs strains, the difference was statistically significant（P〈0.05）, type CTX-M positive strains compared with negative strains in ceftriaxone, cefotaxime and aztreonam resistance rate significantly the difference of antibiotic（P〈0.05）, type SHV positive strains compared with negative strains, antibiotic ceftazidime and piperacillin / tazobactam resistance rate was significantly difference（P〈0.05）. Conclusion The detection of Klebsiella pneumoniae producing ESBLs enzyme and ESBLs gene, ESBLs gene analysis of the epidemic situation and the common genes and antibiotic resistance, and provide a reliable basis for guiding the rational drug use.