产超广谱β-内酰胺酶大肠埃希菌耐药性及基因型分析

目的:了解某医院分离产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的耐药性和基因型，为临床合理用药提供依据。方法:收集大肠埃希菌544株，其中161株为产ESBLs菌株。采用VITEK 2 Compact分析仪进行药敏检测，双纸片协同试验确证产ESBLs菌株，PCR法扩增耐药基因。结果:产ESBLs菌株对多数抗菌药物的耐药率高于不产ESBLs菌株（P<0.05~P<0.01）。161株产EBSLs菌株携带CTX-M-9型基因98株、TEM型84株、CTX-M-1型62株、OXA-2型15株、OXA-10型7株、SHV型5株。CTX-M-1型和TEM+CTX-M-1型菌株对头孢他啶的耐药率分别为43.5%、59.1%明显高于CTX-M-9型和TEM+CTX-M-9型菌株15%、11.8%的耐药率（P<0.05和P<0.01）。结论:该院产ESBLs大肠埃希菌的基因型主要为CTX-M与TEM型，产ESBLs菌株对多数抗菌药物的耐药性高于不产ESBLs菌株。

Analysis of drug resistance and genotypes of ESBLs-producing Escherichia Coli

Objective:To investigate the drug resistance and genotype of Extended-spectrum β-lactamases(ESBLs) producing Escherichia coli,and provide the basis for clinical rational drug use.Methods:Among 544 Escherichia coli strains,161 ESBLs strains were identified.Bacterial susceptibility testing of ESBLs strains was detected using VITEK 2 Compact analyzer.The ESBLs strains were confirmed by double-disk synergy test,and the resistance genes were detected by PCR.Results:The resistance rate of ESBLs-producing strains to most antimicrobial agents were higher than those of non-ESBLs-producing strains(P<0.05 to P<0.01).Among 161 strains of EBSLs,CTX-M-9 genotype in 98 stains,TEM genotype in 84 strains,CTX-M-1 genotype in 62 strains,OXA-2 genotype in 15 strains,OXA-10 genotype in 7 strains,and SHV genotype in 5 strains were identified.The drug resistance rates of CTX-M-1 genotype and TEM + CTX-M-1 genotype strains to ceftazidime(43.5% and 59.1%) were significantly higher than those of CTX-M-9 genotype and TEM+CTX-M-9 genotype strains(15% and 11.8%)(P<0.05 to P<0.01).Conclusions:The TEM and CTX-M are the main genotype of ESBLs-producing Escherichia coli.The drug resistance of ESBLs-producing strains to most antibiotics is higher than that of non-ESBLs-producing strains.