临床分离产超广谱β-内酰胺酶大肠埃希菌耐药基因分型研究

Study on genotyping of drug resistant gene in ESBLs-producing Escherichia coli from clinical isolates

目的对本院分离的产ESBLs大肠埃希茵进行耐药基因分型研究,为指导临床合理用药提供依据。方法根据美国临床和实验室标准协会(CLSI)标准,进行产ESBLs大肠埃希菌的初筛确证实验得到的产ESBLs大肠埃希菌28株,采用PCR方法进行耐药基因的分型研究。结果 28株产ESBLs大肠埃希菌中,TEM型为11株(39.29%),SHV型为6株(21.43%),非TEM非SHV细菌有9株(32.14%),TEM型对氨苄西林100%耐药,而SHV型主要对三代头孢类抗生素耐药,其治疗的首选药物为亚胺培南。结论本院检出的产ESBLs大肠埃希菌主要型别为TEM型,耐药基因分型研究将为临床用药和医院感染监控提供较有价值的参考。

Objective To analyze the current resistance genotyping of ESBLs-producing Escherichia coli（ E. coli） in our hospital to provide basis for reasonable drug usage. Methods 28 clinical strains of ESBLs-producing E. coli were confirmed by CLSI standard,and genotyping of ESBLs-producing E. coli was analyzed by PCR. Results Among the 28 strains of ESBLs-producing E. coli,there were 11 strains of TEM（ 39. 29%）,9 strains of neither TEM nor SHV（ 32. 14%） and 6 strains of SHV（ 21. 43%）. The resistance to ampicillin of TEM was 100%. SHV type showed high resistance to the 3rdgeneration cephalosporin antibiotics,and imipenem was the most effective drugs against ESBLs-producing Escherichia coli. Conclusion TEM was the most prevalent genotype in our hospital,and the typing of resistance genes will provide valuable reference for clinical drug use and hospital infection control.