ICU产ESBLs大肠埃希菌耐药性及基因型分析

目的了解医院重症监护病房(ICU)产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的耐药性及β-内酰胺酶基因型分布特点。方法采用BD Phoenix 100全自动微生物分析仪进行细菌鉴定和药物敏感试验,聚合酶链反应检测β-内酰胺类耐药相关基因,包括TEM、CTX-M-1群、DHA、SHV、oprD2、GES、OXA和VIM。结果 51株产ESBLs大肠埃希菌呈现多重耐药,对亚胺培南、哌拉西林-他唑巴坦和阿米卡星的耐药率分别为2.0%、8.0%和11.8%,其余14种抗生素的耐药率为54.9%~100.0%。51株产ESBLs大肠埃希菌共检出TEM、CTX-M-1群、SHV和oprD2等4种β-内酰胺酶基因,其阳性率分别为76.50%、37.3%、5.9%和31.4%。结论 ICU分离的产ESBLs大肠埃希菌多重耐药严重,携带的β-内酰胺酶基因以TEM为主。

ANALYSIS OF DRUG-RESISTANCE AND GENOTYPES OF ESBLs-PRODUCING ESCHERICHIA COLI IN ICU

Objective To investigate drug-resistance and resistant genes of extended-spectrum-beta-lactamases(ESBLs)-producing Escherichia coli isolated from ICU. Methods BD phoenix 100 automatic microbial analyzer was used for species identification and drug susceptibility test.PCR assay was applied to detect β-lactamase resistant genes,which included TEM,CTX-M-1,DHA,SHV,oprD2,GES,OXA and VIM. Results Fifty-one strains of ESBLs-producing Escherichia coli exhibited multiple-drug-resistance,the resistant rates to Imipenem,piperacillin/Tazobactam and Amikacin were 2.0%,8.0% and 11.8%,respectively.The resistant rates to other 14 antibiotics ranged 54.9% to 100.0%.Four β-lactamases resistant genes including TEM,CTX-M-1,SHV and oprD2 in 51 isolates were identified,with their positive rates being 76.5%,37.3%,5.9% and 31.4%,respectively. Conclusion The multiple-drug-resistance of ESBLs-producing Escherichia coli isolated from ICU samples is severe.TEM type β-lactamases was the main type of ESBLs-producing Escherichia coli in ICU identified in this study.