多药耐药大肠埃希菌老年患者分离株抗菌制剂11种外排泵基因研究

目的了解多药耐药大肠埃希菌中外排泵基因的存在情况。方法微量稀释法检测耐药菌株的药敏结果,采用聚合酶链反应（PCR）扩增法,检测11种抗菌制剂外排泵基因：emrB、emrD、emrE、mdfA、sugE、mdtI、tehA、oqxA、qacE△1、qacEs、mr-2等11种抗菌制剂外排泵基因,扩增产物纯化后基因测序。结果大肠埃希菌对阿米卡星耐药率为60%,对复方新诺明耐药率为95%,对第三代头孢菌素耐药率为100%（均为产ESBLs菌株）,外排泵基因检出率分别为emrB 95.0%、emrD 75.0%e、mrE 50.0%、mdfA 80.0%、sugE 70.0%、mdtI 80.0%、qacE△1 80.0%、tehA 80.0%、oqxA 15.0%,qacE、smr-2基因均未检测到,最少者检出1种基因,最多1株检出9种基因。结论本组分离的大肠埃希菌对β-内酰胺类、氨基糖苷类、喹诺酮类、磺胺类、氯霉素等抗菌药物呈多重耐药,可能与细菌携带多种抗菌制剂（包括灭菌剂、消毒剂、抗菌药物等）外排泵基因相关。

Eleven species of efflux pump genes in multidrug-resistant Escherichia coli isolates from the strains of elderly patient

To investigate the carrying situation of 11 species of drug efflux pump genes in multidrug resistant strains of Escherichia coli.Antibiotic sensitivity tests were performed by microdilution test.All 11 kinds of drug efflux pump gene（emrB,emrD,emrE,mdfA,sugE,mdtI,tehA,oqxA,qacE△1,qacE,smr-2） were detected by polymerase chain reaction（PCR）.And the PCR products were purified and sequenced.The rate of Escherichia coli resistant to amikacin was 60%,to sulfamethoxazole was 95%,and to the third-generation cephalosporin was 100%（all ESBLS-producing strains）.The positive rates of efflux pump genes were detected（emrB 95.0%,emrD 75.0%,emrE 50.0%,mdfA 80.0%,sugE 70.0%,mdtI 80.0%,qacE△1 80.0%,tehA 80.0%,oqxA 15.0%,respectively）.However,the other 2 kinds of efflux pump genes could not be detected.Furthermore,efflux pump genes were detected for at least one kind of gene,and one strain was detected to carry 9 kinds of genes.It＇s indicated that the separation of the Escherichia coli group strains to β-lactams,aminoglycosides,quinolones,sulfonamides,chloramphenicol and other antibiotics were multi-drug resistant.These may carry a variety of antimicrobial agents and bacteria（sterilization,disinfectants,antibiotics,etc.）,and express multi-drug resistance.