普外科患者切口感染大肠埃希菌耐药性分析及耐药基因检测

Analysis of the drug resistance of Escherichia coli infecting surgical wounds of patients in General Surgery a nd detection of drug resistance genes

目的分析普外科患者切口感染大肠埃希菌的耐药性并检测耐药基因,以期为临床抗感染治疗提供参考。方法收集2014-2016年131例本院普外科诊治的切口感染患者临床资料,从切口分泌物中分离大肠埃希菌。采用全自动细菌鉴定仪鉴定菌株。采用K-B法检测大肠埃希菌的耐药情况,PCR扩增检测菌株的耐药基因。结果共分离出16株大肠埃希菌,对诺氟沙星、氧氟沙星、环丙沙星、阿米卡星、庆大霉素和妥布霉素的耐药率分别为18.75%、12.50%、6.25%、12.50%、43.75%和56.25%。PCR检测结果显示,aac(3)-II基因检测阳性率为50.00%、aac(6')-I基因阳性率为12.50%、qnr基因阳性率为18.75%、parC基因阳性率为6.25%、gyrA基因阳性率为6.25%。结论大肠埃希菌对多数常见药物均产生了耐药性,但对加替沙星仍敏感;耐药基因分布与大肠埃希菌耐药性有直接关系,及时监测耐药基因分布情况对控制大肠埃希菌耐药性具有重要意义。

Objectives To analyze the drug resistance of Escherichia coli infecting surgical wounds of patients in General Surgery and to detect its drug resistance genes in order to provide a reference for the clinical treatment of infectionsMethods Clinical data on 131 patients in General Surgery with infected surgical wounds were collected from 2014-2016,and E.coli was isolated from wound secretions.Bacterial strains were identified using an automated microbe identification system.The drug resistance of E.coli was determined using the K-B method,and the drug resistance genes of strains were detected via amplification with PCR. Results Sixteen strains of E.coli were isolated from samples.The resistance of the strains to norfloxacin was 18.75%,their resistance to ofloxacin was 12.50%,their resistance to ciprofloxacin was 6.25%,their resistance to amikacin was 12.50%,their resistance to gentamicin was 43.75%,and their resistanc0% of strains,the aac（6＇）-I gene was detected in 12.50%,the qnr gene was detecte e to tobramycin was 56.25%.PCR results indicated that the aac（3）-II gene was detected in 50.0din 18.75%%,the parC gene was detected in 6.25%,and the gyrA gene was detected in 6.25%. Conclusion E.coli was resistant to most commonly used drugs,but it was still sensitive to gatifloxacin.The distribution of drug resistance genes was directly related to the drug resistance of E.coli,and prompt monitoring of the distribution of drug resistance genes is crucial to controlling the drug resistance of E.coli.