产超广谱β-内酰胺酶大肠埃希菌耐药表型和基因型分析

    Study on the antimicrobial resistance and genotypes of extended-spectrum β-lactamases in Escherichia coli isolates

    • 摘要: 目的:分析临床分离大肠埃希菌耐药性、产超广谱β-内酰胺酶(ESBLs)阳性率及耐药基因之间的关系。方法:用K-B法检测117株大肠埃希菌耐药性,用酶抑制剂增强实验纸片法检测产ESBLs菌株,用PCR法检测相关耐药基因,用DNA序列分析确认基因亚型。结果:117株大肠埃希菌产ESBLs 49株,阳性率41.9%。产ESBLs菌株对青霉素类和第一、第二代头孢菌素耐药率100%,对第三代头孢菌素中头孢哌酮、头孢噻肟和头孢曲松耐药率>95%,对酶抑制剂哌拉西林/三唑巴坦和头孢哌酮/舒巴坦耐药率<20%,未检测到亚胺培南耐药株。非产ESBLs菌株耐药率明显低于产ESBLs菌株。49株产ESBLs菌株PCR均扩增到CTX-M型耐药基因,44株扩增到TEM型基因,未扩增到其他基因型。DNA序列分析证实为CTX-M-14亚型、CTX-M-3亚型和广谱酶TEM-1亚型基因。结论:大肠埃希菌产ESBLs较高,耐药显著;耐药基因以CTX-M-14亚型为主,其次为CTX-M-3亚型,尚未检出其他ESBLs基因。TEM-1亚型广谱内酰胺酶基因在大肠埃希菌中普遍存在。

       

      Abstract: Objective: To study the relationship between antibiotic resistance and extended-spectrum β-lactamases(ESBLs) genes in clinical isolates of E.coli.Methods: Antibiotic susceptibility was tested by Kirby-Bauer disk diffusion method and ESBLs production was detected by CLSI phenotypic confirmarory test in E.coli isolates.The β-lactamases genes were identified by PCR and sequencing.Results: Fourty-nine of 117 strains collected were ESBLs-producing E.coli and all of them were resistant to ampicillin,piperacillin,cefazolin,cefuroxime.The resistance rates to cefotaxime,ceftriaxone,cefpodoxime,and cefoperazone were more than 95%,but only 41.8% to ceftazidime.The resistance rates to piperacillin-tazobactam and cefoperazone-sulbactam were 8.1% and 18.4%,respectively,to imipenem was 0.0%.ESBLs gene was found in all ESBLs-producing isolates,and CTX-M-14 genotype was dominated(87.8%).Conclusions: ESBLs-producing E.coli are prevelance in our hospital and most of them are multidrug resistant strains.CTX-M-14 is the main genotype of ESBLs,and the second is CTX-M-3 genotype.No other genotype of ESBLs was detected.

       

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