山东某生猪养殖县农村居民产ESBLs肠杆菌科细菌流行现状及耐药情况分析

Prevalence and drug resistance of extended-spectrum beta-lactamases producing Enterobacteriaceae among rural residents in villages with pig-breeding farms in Shandong province

目的了解产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌在山东某生猪养殖县农村居民中的流行现状及耐药情况,为控制抗生素耐药提供参考依据。方法于2016年7月采用随机抽样方法在山东省东部某畜牧养殖县抽取4个村160名农村常住居民作为研究对象,使用e Swab采样管采集其粪便样本,接种于ESBLs筛选培养基,质谱鉴定菌株型别,根据2015版美国临床和实验室标准进行ESBLs确证试验和药物敏感性试验。结果山东某生猪养殖县160份农村居民的粪便样本中有132份产ESBLs,携带率为82.5%;132份阳性标本中共包含产ESBLs的大肠埃希菌184株和肺炎克雷伯菌23株,共207株菌株;产ESBLs的大肠埃希菌和肺炎克雷伯菌对头孢噻肟、四环素、复方新诺明、环丙沙星、氟苯尼考、庆大霉素、哌拉西林/他唑巴坦、磷霉素、阿莫西林/克拉维酸、呋喃妥因、阿米卡星、头孢西丁、美罗培南、替加环素的耐药率分别为100.0%和100.0%、87.0%和95.7%、82.1%和100.0%、64.7%和30.4%、56.5%和43.5%、53.8%和60.9%、31.0%和78.3%、29.9%和69.6%、20.1%和52.2%、13.0%和30.4%、7.1%和0、4.9%和0、0和0、0和56.5%;产ESBLs的大肠埃希菌和肺炎克雷伯菌中,耐1~2、3~5、6~8和≥9种药物的比例分别为7.3%、50.7%、39.6%和2.4%。结论产ESBLs肠杆菌科细菌在山东农村生猪养殖地区的携带率较高,对头孢噻肟、四环素、复方新诺明等药物耐药性较强。

Objective To evaluate the prevalence and antibiotic resistance of extended-spectrum beta-lactamases（ESBLs） producing Enterobacteriaceae among rural residents in villages with pig-breeding farms in Shandong province and to provide references for the control of antibiotic resistance of the pathogens.Methods Totally 160 permanent rural residents aged ≥ 18 years were randomly selected from 4 villages with pig-breeding farms in a county in Shandong province and fecal samples were collected from the participants using eSwab sampling tube in July 2016.ESBLs-producing E.coli and K.pneumonia strains were isolated with ESBLs screening medium and identified with matrix-assisted laser desorption/ionization-time of flight mass spectrometry （MALDI-TOF MS）.ESBLs confirmation testing and antimicrobial susceptibility testing were performed according to Clinical Laboratory Standards Institute （CLSI） guidelines.Results Of the 160 fecal samples,132 were ESBLs producing bacteria positive and the carrying rate of ESBLs producing bacteria was 82.5% for the participants.Totally 207 ESBLs producing bacteria strains,including 184 ESBLs producing E.coli and 23 ESBLs producing K.pneumonia,were isolated from the 132 positive specimens.The antibiotic resistant rate for the ESBLs producing E.coli and K.pneumonia strains were 100% and 100% to cefotaxime,87.0% and 95.7% to tetracycline,82.1% and 100.0% to co-trimoxazole,64.7% and 30.4% to ciprofloxacin,56.5% and 43.5% to florfenicol,53.8%and 60.9% to gentamicin,31.0% and 78.3% to piperacillin-tazobactam,29.9% and 69.6% to fosfomycin,20.1% and 52.2% to amoxicillin-clavulanic acid,13.0% and 30.4% to nitrofurantoin,7.1% and 0 to amikacin,4.9% and 0 to cefoxitin,0 and 0 to meropenem,and 0 and 56.5% to tigecycline,respectively.Among all ESBLs producing E.coli and K.pneumonia strains,the proportions of resistant to 1-2,3-5,6-8,and ≥9 antibiotics were 7.3%,50.7%,39.6%,and 2.4%,respectively.Conclusion The carrying rate of ESBLs producing bacteria are high and the isolated fecal ESBLs producing bacteria strains are highly resistant to cefotaxime,tetracycline,co-trimoxazole among rural adult residents in villages with pig-breeding farms in Shandong province.