老年脑卒中患者分离的大肠埃希菌耐药特点及机制研究

Characteristics and mechanism of drug resistance of E.coli from elder stroke patients

目的了解老年脑卒中住院患者分离的大肠埃希菌耐药特点、超广谱β-内酰胺酶(ESBLs)检出率、ESBLs基因型及携带模式。方法回顾分析本院老年脑卒中住院患者分离的206株大肠埃希菌对16种抗生素耐药性,双纸片协同试验检测大肠埃希菌产ESBLs率,PCR及产物测序确定菌株ESBLs基因型及携带模式。结果未见亚胺培南和美罗培南耐药株,49. 5%的菌株产ESBLs,产ESBLs菌对大部分抗菌药物的耐药率明显高于非产ESBLs株,TEM和CTXM基因型是ESBLs优势编码基因,TEM+CTX-M携带模式最常见。结论本地区大肠埃希菌对碳青霉烯类抗生素敏感,产ESBLs菌株耐药率远较不产ESBLs菌株高,应加强对大肠埃希菌ESBLs监测,有效控制产ESBLs大肠埃希菌的散播以及耐药基因的传播。

Objective To study the drug resistance,extended spectrumβ-lactamases(ESBLs)-production rate,ESBLs genotype and carrying mode of Escherichia coli(E.coli)isolates from elderly stroke patients.Methods We retrospectively analyzed 206 E.coli isolates resistant to 16 antibiotics.ESBLs production of 206 E.coli isolates were detected by double disk synergy test.ESBLs genotype and carrying mode of 206 isolates were detected by PCR and sequencing.Results All of isolates were susceptible to imipenem and meropenem.The detection rate of ESBLs-producing isolates was 49.5%.The resistance rates of ESBLs-producing isolates were significantly higher than those of non-ESBLs producing isolates to most antibacterial drugs.TEM and CTX-M are the dominant ESBLs genotypes,and TEM+CTX-M carrying mode is the most common.Conclusion All 206 isolates were sensitive to carbapenems antibiotics.The drug resistance rate of ESBLs producing isolates were much higher than that of non-ESBLs producing isolates.Surveillance should be intensified to E.coli producing ESBLs,so as to effectively control the ESBLs-producing Escherichia coli and the spread of drug resistance genes.