临床分离大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株及其耐药基因型研究

Study on the drug-resistant genes of ESBLs producing-Escherichia coli and Klebsiella pneumoniae

目的研究分离的大肠埃希菌及肺炎克雷伯菌的产ESBLs菌株的耐药情况及耐药基因的表达。方法选取2014年1月至2015年12月我院的514例感染患者的样本作为研究对象,分离大肠埃希菌及肺炎克雷伯菌,PCR检测产ESBLs菌株的TEM、SHV、CTX-M-Ga、CTX-M-Gb及CTX-M-Gc的表达情况。结果所有样本分离出大肠埃希菌198株,其中产ESBLs菌株101株(51.01%):TEM阳性27株(26.73%),SHV阳性32株(31.68%),CTX-M-Ga阳性17株(16.83%),CTX-M-Gb阳性13株(12.87%)及CTX-M-Gc阳性7株(6.93%)。肺炎克雷伯菌114株,其中产ESBLs菌株61株(53.51%):TEM阳性11株(18.03%),SHV阳性14株(22.95%),CTX-M-Ga阳性11株(18.03%),CTX-M-Gb阳性13株(21.31%)及CTX-M-Gc阳性7株(11.48%)。结论对大肠埃希菌和肺炎克雷伯菌进行ESBLs菌株筛选及耐药基因检测,对指导临床抗菌药物的合理应用具有重要意义。

Objective To study the drug resistance status and expression related genes of ESBLs producing-Escherichia coli and Klebsiella pneumonia.Methods From January 2014 to December 2015,samples from 514 patients were collected and diagnosed with pathogen analysis.ESBLs producing-Escherichia coli and Klebsiella pneumonia were isolated and drug-resistant genes were detected with PCR.Results 198 Escherichia coli strains were isolated,among which 101 were ESBLs producing strains（51.01%）.TEM positive was 27 strains （26.73%）,SHV positive was 32 strains（31.68%）,CTX-M-Ga positive was 17 strains（16.83%）,CTX-M-Gb positive was 13 strains（12.87%）and CTX-M-Gc positive was 7 strains（6.93%）.114 Escherichia coli strains were isolated,among which 61 were ESBLs producing strains（53.51%）.TEM positive was 11 strains（18.03%）,SHV positive was 14 strains（22.95%）,CTX-M-Ga positive was 11strains（18.03%）, CTX-M-Gb positive was 13 strains（21.31%）and CTX-M-Gc positive was 7 strains（11.48%）.Conclusion Screening of ESBLs producing-Escherichia coli and Klebsiella pneumonia and detection of drug-resistant genes demonstrate significance in reasonable use of antibiotics.