社区获得性尿路感染产ESBLs大肠埃希菌的耐药性和基因型研究

Resistance and genotype research of E. coli producing ESBLs from community acquired urinary tract infection

目的探讨社区获得性尿路感染患者中分离的产ESBLs大肠埃希菌的耐药性和基因型,为临床合理使用抗生素提供科学依据。方法收集社区尿路感染分离的321株大肠埃希菌,用PCR扩增技术检测ESBLs的基因型,用Phoenix100型全自动微生物分析仪进行药敏检测。结果 321株大肠埃希菌中共分离出产ESBLs菌株173株(53.9%),ESBLs大肠埃希菌对舒普深、特治星、呋喃妥因敏感性较好,对氨苄西林、头孢唑啉等高度耐药。PCR扩增结果显示,90.2%产酶株携带CTX-M基因,35.2%产酶株携带TEM基因,3.0%产酶株携带SHV基因。结论社区尿路感染中产ESBLs菌株日益增多,耐药现象较严重,基因型以CTX-M和TEM型多见。

Objective To investigate the drug resistance and genotype of extended-spectrumβ-Lactamases（ ESBLs）-producing Escherichia coli（ E. coli） isolated from patients with community-acquired urinary tract infection（ CA-UTI）,so as to provide scientific basis for clinical rational use of antibiotics. Methods 321 strains of E. coli isolated from patients with CA-UTI were collected,ESBLs genotype was detected with PCR amplification technology,drug susceptibility was tested by Phoenix 100 automatic microbial analyzer. Results A total of 173 ESBLs isolates（ 53. 9%） were isolated from 321 strains of Escherichia coli. ESBLs-producing Escherichia coli strains were highly sensitive to superamide,estrogen and nitrofurantoin,and were highly resistant to ampicillin and cefazolin. PCR amplification showed that 90. 2% of the enzyme-producing strains carried CTX-M gene,35. 2% of the enzyme-producing strains carried TEM gene,and 3. 0% of the enzyme-producing strains carried SHV gene. Conclusion More ESBLs strains grow in CA-UTI,drug resistance phenomenon is relatively serious,CTX-M and TEM were the common genotypes.