大肠埃希菌和肺炎克雷伯菌ctx-m型esbls的分析

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1、TheStudyofCTX·-MtypeESBLsinEscherichiacoli[Objective]andKlebsiellapneumoniaeAbstractproductionofExtendedspectrum13-1actamases(ESBLs)isanimportantmechanismofresistanceto13-1actamantibioticinenterobacteriaceae．ESBLsisalargefamilyofp-lactamasescanhydrolyzepenicillins，thef

2、irsttofourthgenerationcephalosporinsandmonobactams．ESBLsaremainlyproducedbyKlebsiellapneumoniaeandEscherichiacoli．ESBLs—producingstrainshavebeenwidespreadintheworld．ThegenotypeofESBLproducingstrainsdiffersindifferentcountriesorareasbecauseofthedifferentuseofantibacteri

3、alagents．ItisshowedthatCTX—MtypearethemostwidespreadESBLsinmanycountry．InordertoclarifythesituationofCTX-MtypeenzymesspreadedinShenzhenarea．215ESBLs-producingEscherichiacoliandKlebsiellapneumoniaeisolatesfromShenzhenpeople、ShospitalwereanalysedfortheirCTX-Mgeneandantib

4、ioticresistance．[Methods](1)215ESBLs—producingstrainswereselectedfromisolatesbetweenJune2000andAugust2003inShenzhenpeople、Shospitalbythemethodofphenotypicconfirmatorytestwhichrecommendedbythe3NCCLS．Thestrainsincluded151Escherichiacoliand64Klebsiellapneumonlae·(2)Thepla

5、smidsintheseisolateswereobtainedbyalkalinelysismethod．(3)CTX—Mgeneweredetectedbypolymerasechainreaction(PCR)．ThreepairofspecialprimersforCTX—M一1，CTX—M-2andCTX—M-9genewereused．(4)ThegenesequencingwasperformedbyusingABIPRISM377DNAsequencer．(5)MICsofthestrainsproducingCTX

6、—Menzymeweredeterminedbytheuseofagardilutionmethod[Results](1)215ESBLs—producingstrainsweredetectedin535clinicalisolates，sharedthepositiverateof40．2％，whichincluded151Escherichiacoliand64Klebsiellapneumoniaestrains．(2)Inall215strains，180strains(83．7％)producedCTX-MtypeES

7、BLs，includingCTX—M一14(143strains)，CTX—M一15(12strains)，CTX．M．9(9strains)，CTX—M一3(5strains)，CTX—M一13(4strains)，4strainsproducedCTX—M一14andCTX—M一3，onestrainproducedCTX-M_14andCTX—M．15．AnewCTX—MtypeIMactamasewasdetectedintwoKlebsiellapneumoniaeisolatesandnamedtobeCTX—M一38．

8、4(3)ThesusceptibilityrateofallCTX-M-producing．strainstoImipenem，Amikacin，Piperacillin／tazobactam，CefoxitinandAmoxicil