产CTX型超广谱β-内酰胺酶的大肠埃希菌基因分析及耐药特征

山东大学学报(医学版) ›› 2013, Vol. 51 ›› Issue (11): 61-65.

产CTX型超广谱β-内酰胺酶的大肠埃希菌基因分析及耐药特征

潘玫1，李稳1，王靖男1，张苗1，刘泉1，陈山2

1.山东中医药大学附属医院检验科，济南 250011; 2.山东大学附属省立医院检验科，济南 250021

收稿日期:2013-04-22 出版日期:2013-11-10 发布日期:2013-11-10
通讯作者: 潘玫，E-mail:sdjnpm2006@126.com; 陈山，E-mail:chsh787@sohu.com
基金资助:
国家自然科学基金(81000869)；济南“泉城学者”建设工程招标课题(Q2-06)

Resistance and genotyping of producing CTX-type extended-spectrum β-lactamase Escherichia coli isolates

PAN Mei1, LI Wen1, WANG Jing-nan1, ZHANG Miao1, LIU Quan1, CHEN Shan2

1. Department of Clinical Laboratory, Affiliated Hospital of Shandong University of
Traditional Chinese Medicine， Jinan 250011， China; 2. Department of Clinical Laboratory,
Shandong Provincial Hospital Affiliated to Shandong University， Jinan 250021， China

Received:2013-04-22 Online:2013-11-10 Published:2013-11-10

摘要/Abstract

摘要：

目的探讨产超广谱β-内酰胺酶(ESBLs)大肠埃希菌blaCTX-M基因分型及相应耐药特征。方法采用双纸片法检测ESBLs， PCR检测blaCTX-M及blaCTX-M-1、-2、-8、-9、25组基因,肉汤稀释法检测抗菌药物MIC值。结果 83株大肠埃希菌中，45株ESBLs表型确证实验阳性，PCR扩增结果显示44株blaCTX-M扩增阳性，其中12株单独检测出blaCTX-M-1组，29株单独检测出blaCTX-M-9组，3株同时具有blaCTX-M-1组和blaCTX-M-9组，未检测出blaCTX-M-2、-8、-25组。所有菌株对亚胺培南皆敏感,对头孢唑林、头孢噻肟、头孢曲松皆耐药。CTX-M-1组菌株对头孢他啶、头孢吡肟的耐药率皆为91.6%(11/12)，氨曲南耐药率为100%，左旋氧氟沙星、庆大霉素耐药率分别为100%和83.3%(10/12)。CTX-M-9组菌株对头孢他啶、头孢吡肟耐药率分别为44.8%(13/29)、41.4%(12/29)，氨曲南耐药率为55.2%(16/29)，左旋氧氟沙星耐药率为89.7%(26/29)、庆大霉素耐药率为58.6%(17/29)。CTX-M-1、-9两组菌株对头孢他啶、头孢吡肟、氨曲南耐药率差异有统计学意义(P＜0.05)。结论产ESBLs大肠埃希菌基因型以blaCTX-M为主， blaCTX-M-9组在blaCTX-M基因中占优势。CTX-M-9组菌株对头孢他啶、头孢吡肟、氨曲南敏感性高于CTX-M-1组。

关键词: 大肠埃希菌；CTX-M型超广谱β-内酰胺酶；基因型；耐药特征

Abstract:

Objective To detect the genotypes and resistance of producing CTX-M type extended-spectrum β-lactamase E.coli isolates. Methods ESBLs was confirmed with phenotypic confirmatory test; blaCTX-M, blaCTX-M-1, -2, -8, -9, -25 genotypes were detected with polymerase chain reaction (PCR); MIC was determined with broth dilution method. Results Of the 83 Escherichia coli isolates, 45 were ESBLs-producing strains, and 44 produced CTX-M-type ESBLs. Of these 44 isolates, 12 produced blaCTX-M-1, 29 produced blaCTX-M-9 and 3 produced both blaCTX-M-1 and blaCTX-M-9. The blaCTX-M-2, blaCTX-M-8 and blaCTX-M -25 genotypes were not detected. No imipenem-resistant strains were found. All 44 strains showed resistance to cefazolin, cefotaxime, and ceftriaxone. The drug resistance rates of CTX-M-1 strain to ceftazidime, cefepime, aztreonam, levofloxacin and gentamicin were 91.6%, 91.6%, 100%, 100% and 83.3%. The drug resistance rates of CTX-M-9 strain to ceftazidime, cefepime, aztreonam, levofloxacin and gentamicin were 44.8%, 41.4%, 55.2%, 89.7% and 58.6%. There was significant difference between the two rates concerning ceftazidime, cefepime, and aztreonam (P＜0.05). Conclusion The blaCTX-M is the major genotype producing ESBLs, in which blaCTX-M-9 is dominant. CTX-M-9 strains are more sensitive to ceftazidime, cefepime and aztreonam than CTX-M-1 strains.

Key words: Escherichia coil; CTX-M type extended-spectrum β-lactamase; Genotype; Resistance

中图分类号:

R378.21

潘玫1，李稳1，王靖男1，张苗1，刘泉1，陈山2. 产CTX型超广谱β-内酰胺酶的大肠埃希菌基因分析及耐药特征[J]. 山东大学学报(医学版), 2013, 51(11): 61-65.

PAN Mei1, LI Wen1, WANG Jing-nan1, ZHANG Miao1, LIU Quan1, CHEN Shan2. Resistance and genotyping of producing CTX-type extended-spectrum β-lactamase Escherichia coli isolates[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(11): 61-65.

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