社区及院内感染产超广谱β-内酰胺酶大肠埃希菌耐药及耐消毒剂基因分析

目的了解本地区社区获得性和医院内感染大肠埃希菌产超广谱β-内酰胺酶（ESBLs）的发生率，分析和研究其耐药基因和耐消毒剂基因的携带情况。方法收集从临床标本分离的大肠埃希菌95株，经ESBLs确证试验将其中38株阳性菌株分为医院与社区获得性感染2组，用聚合酶链反应（PCR）检测耐药基因TEM、SHV、CTX-M-1以及耐消毒剂基因qacE△1-sull。结果社区获得性大肠埃希菌ESBLs的检出率为30％，医院内感染大肠埃希菌ESBLs的检出率为55％。17株社区获得性感染产ESBLs大肠埃希菌耐药基因TEM的检出率为71％，CTX-M-1的检出率为35％，SHV的检出率为6％，耐消毒剂基因qacE△1-sull的检出率为53％。21株医院内感染产ESBLs大肠埃希菌耐药基因TEM的检出率为71％，CTX-M-1的检出率为43％，SHV的检出率为14％，耐消毒剂基因qacE△1-sull的检出率为62％。结论本地区医院内感染大肠埃希菌ESBLs的检出率明显高于社区获得性感染大肠埃希菌ESBLs的检出率。社区获得性和医院内感染ESBLs大肠埃希菌耐药基因均以TEM型为主，耐消毒剂基因的携带率2组没有组间差异。

Analysis of drug resistant gene and disinfectant resistant gene in extended-spectrum β-lactamases-producing Escherichia coli isolated from hospital and community acquired infections

Objective To investigate the incidence of extended-spectrum β-lactamases （ESBLs） produced by Escherichia coli （E.coli） isolated from hospital acquired infections （HAI） and community acquired infections （CAI） and to study and analyze the drug resistant and disinfectant resistant genes of ESBLs-producing E. coli. Methods Among 95 unrepeated strains isolated from clinic, 38 positive strains tested by ESBLs confirmatory test were collected from HAI and CAI subjected to detection for drug resistant gene TEM, SHV, CTX-M-1 and for disinfectant resistant gene qacE△1-sull by polymerase chain reaction （PCR）. Results The positive rate of ESBLs-producing E. coli isolated from CAI was 30% （ 17 strains）, and the one isolated from HAI was 55% （21 strains）. Among the 17 strains from CAI, the positive rate of drug resistant gene TEM, CTX-M-1, SHV were 71% , 35% and 6% respectively, while the one of disinfectant resistant gene qacE△1-sull was 53%. Among the 21 strains from HAI, the positive rate of drug resistant gene TEM, CTX-M-1, SHV were 71% , 43% , 14% respectively, while the one of disinfectant resistant gene qacE△1-sull was 62%. Conclusions The positive rate of ESBLs-producing E. coli from HAI is far more than that from CAI. The main drug resistant gene of ESBLs-producing E. coli isolated from HAI and CAI is TEM, while the incidence of disinfectant resistant gene has no significant difference between the two groups.