检验医学与临床2016，Vol.13Issue(6)：734-737,740,5.DOI:10.3969/j.issn.1672-9455.2016.06.005
医院获得性尿路感染大肠埃希菌ESBLs基因型与耐药性分析
Analysis on ESBLs genotypes and drug resistance of hospital-acquired uropathogenic E .coli
摘要
Abstract
Objective To understand the characteristics of drug resistance and ESBLs genotypes of hospital-acquired uropathogenic E .coli(HA-UPEC) for guiding clinical antibacterial drug use of urinary tract infection and controlling hospital-acquired infections .Methods A total of 168 HA-UPEC strains isolated from the inpatients were collected .The PCR amplification was used to detect the main ESBLs genotypes and their resistance characteristics to common 16 kinds of antibiotics were analyzed .Results The resistance rates of 168 strains of HA-UPEC to com-pound sulfamethoxazole ,ampicillin ,cefazolin ,cefuroxime ,cefotaxime ,ceftriaxone ,and ciprofloxacin were up to more than 70% .Among 16 kinds of common antibacterial drugs ,cefoperazone/sulbactam ,piperacillin/tazobactam ,amikacin and imipenem had lower resistance rate .Compared with non-ESBLs producing E .coli ,ESBLs-producing E .coli showed higher resistance to penicillins ,cephalosporins and fluoroquinolones .According to the drug susceptibility spectrum ,168 strains of HA-UPEC were divided into five supergroups group A-E ,and ESBLs producing E .coli strains were mainly distributed in the group A ,B and C .CTX-M was main ESBL genotype(109 strains) ,followed by TEM (48 strains) .59 strains produced ≥ 2 kinds of ESBLs and ESBLs was not detected in 3 strains .The relation a-nalysis between drug resistance cluster grouping and ESBLs genotypes displayed that TEM had the highest distribu-tion rate in the group D(65 .2% ) ;SHV was not detected in the group C ,SHV had different distribution in the group A and B ;the CTX-M distribution difference among 4 groups had no statistical significance(P> 0 .05) ,OXA was not detected in the group B and differently distributed between A and B groups .Conclusion The drug resistance of ES-BLs-producing E .coli is serious .The different distribution of four ESBLs genotypes may be one of causes for UPES-BLs drug resistance difference ,and TEM genotype is more sensitive .The CTX-M and SHV genotypes are more drug resistant ;so clinic should strictly and rationally use antibiotics ,timely master the change of ESBLs genotypes and drug resistance ,which is conducive to reduce the generation of E .coli strains causing multi-drug resistant urinary tract infection .关键词
超广谱β-内酰胺酶/医院获得性尿路感染大肠埃希菌/基因型/耐药性Key words
ESBLs/HA-UPEC/genotype/resistance引用本文复制引用
唐春进,杨淑雅,赵瑞珂,余佳佳,邱骏,张险峰,钱雪峰,韩清珍,徐杰..医院获得性尿路感染大肠埃希菌ESBLs基因型与耐药性分析[J].检验医学与临床,2016,13(6):734-737,740,5.基金项目
江苏省卫生厅医学科研项目（Q201401）；苏州市科教兴卫青年科技课题（kjxw2014008）；江苏省研究生培养创新工程项目（KY-LX＿1261）。 （）
