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1、多重PCR检测临床产ESBLs大肠埃希菌的耐药•基因型研究作者:姚杰,陶勇,贾建安,吕晴单位:合肥解放军第105医院检验科(姚杰,贾建安,陶勇);合肥安徽医科大学笫二附属医院检验科(姚杰)【摘要】目的了解产超广谱β■内酰胺酶(ESBLs)大肠埃希菌的耐药性、产ESBLs的阳性率及耐药•基因Z间的关系。方法采用Kirby-Bauer(K-B)琼脂扩散法检测120株临床分离的大肠埃希菌对18种抗生素的耐药性,用酶抑制剂增强实验纸片法检测产ESBLs菌株,运用多重PCR技术检测相关]耐药基因川DNA序列分析确认基因亚型。结果1
2、20株大肠埃希菌产ESBLs的有51株,阳性率为42.5%o120株大肠埃希菌对亚胺培南全部敏感,产ESBLs的大肠埃希菌对头葩II坐咻、头他唾月亏、头他曲松、头殖哌酗、头他他旋等头抱类抗菌药物的耐药•率高达100%;51株产ESBLs菌株其屮46株扩增到CTX-M型耐药•基因,44株扩增到TEM型基因,2株扩增到SHV基因,1株OXA型基因,未检出PER和VEB型。结论大肠埃希菌产ESBLs较高,耐药显著,碳青酶烯类抗生素是目前治疗产ESBLs大肠埃希菌最有效的药物;产ESBLs大肠埃希菌的主要基因型别为CTX-M型和TEM型。
3、【关键词】超广谱&be@■内酰胺酶;大肠埃希菌;多重PCR;耐药性;基因型MultiplexPCRassayforgenotypeofESBLs-producingEscherichiacoliinclinicalisolatesYaoJie,TaoYong,JiaJian*an,etalDepartmentofClinicalLaboratory,theSecondAffiliatedHospitalofAnhuiMedicalUniversity,Hefei230601[Abstract]ObjectiveToinvestig
4、atetheproductionofextended-spectrumβ-lactamases(ESBLs)ofthedrugresistaneeofEscherichiacoliproducingESBLspositiverateandtherelationshipwiththeresistancegene.MethodsTheK・Bagardiffusionassaytheresistanceof120clinicalisolatesofEscherichiacolitothe18kindsofantibiotics
5、,usingenzymeinhibitorsenhancepapertotestphenotypeofESBLs,usingmultiplexPCRtodetectrelatedresistaneegene,andusingDNAsequenceanalysistoconfirmedthegenesubtypes.Results51of120EscherichiacoliproducingESBLs,thepositiveratewas42.5%・Allof120isolatesaresensitivetoimipenem,the
6、antimicrobialresistancerateofESBLs-producingisolatstocefazolin,cefotaxime,ceftriaxone,cefoperazone,ceftazidimeandothercephalosporinswasashighas100%;51strainsproducingESBLswhichamplified46toCTX-M-typeresistancegene,amplifiedby44toTEM-typegenes,twoamplifiedSHVgenesandon
7、eOXA-typegenes・PER-typeandVEB-typewerenegative.ConelusionCarbapenemantibioticsiscurrentlythemosteffectivedrugstotreatinentEscherichiacoliwhichproducingESBLs;themajorgenotypeswereCTX-M-typeandTEM-type.[Keywords]ESBLs;Escherichiacoli;MultiplexPCR;Resistance;Genotype大肠埃希
8、菌是临床感染的主要病原体Z—,由质粒介导的产ESBLs大肠埃希菌又是最常见的耐药菌。随着广谱抗生素尤其是β・内酰胺类抗生素的大量使用,产ESBLs的肠杆菌科细菌耐药性II益严重,而产ESBLs大肠埃希菌是目前医院感染的主要病原菌。近年来,