多药耐药大肠埃希菌携带CTX-M-14与CTX-M-15酶基因的研究

发布时间：2018-11-05 19:45

【摘要】：目的了解多药耐药大肠埃希菌携带质粒介导的CTX-M-14与CTX-M-15酶基因分布及其对常见抗菌药物的耐药性,为临床合理选择抗菌药物提供依据。方法收集2007年7月-2008年7月感染患者送检标本中分离出的大肠埃希菌71株,采用纸片扩散法(K-B法)对其中多耐30株、双耐19株及单耐16株大肠埃希菌进行药物敏感试验,提取质粒DNA,以此为模板采用聚合酶链反应(PCR)法对CTX-M-14与CTX-M-15酶基因进行扩增,PCR产物送上海生工进行基因测序。结果 71株大肠埃希菌耐药模式为多耐30株、双耐19株、单耐16株、全敏6株,分别占42.2%、26.8、22.5%、8.5%;56株多药耐药大肠埃希菌对亚胺培南、阿米卡星的耐药率较低,15.0%,对头孢噻肟、氨曲南、庆大霉素等的耐药率均50.0%;56株多药耐药大肠埃希菌中,44株检出CTXM-14酶基因,28株检出CTX-M-15酶基因,检出率分别为78.6%和50.0%;携带CTX-M-14与CTX-M-15酶基因的多药耐药大肠埃希菌对头孢噻肟、头孢他啶的耐药率分别81.8%、52.2%和96.4%、60.7%,两者相比较,差异有统计学意义(P0.01)。结论多药耐药大肠埃希菌中,含CTX-M-14与CTX-M-15酶基因菌株是常见的,携带CTX-M-14与CTX-M-15酶基因的多药耐药大肠埃希菌对头孢噻肟耐药率高于头孢他啶。
[Abstract]:Objective to investigate the gene distribution of CTX-M-14 and CTX-M-15 enzymes mediated by plasmid carrying multidrug resistant Escherichia coli (MDR) and its resistance to common antimicrobial agents, and to provide evidence for the rational selection of antimicrobial agents in clinical practice. Methods from July 2007 to July 2008, 71 strains of Escherichia coli were collected from infected patients, and 30 strains of Escherichia coli were detected by disk diffusion method (K-B method). Drug sensitivity tests were carried out in 19 strains of double-resistant Escherichia coli and 16 strains of single-resistant Escherichia coli. Plasmid DNA, was extracted as template to amplify CTX-M-14 and CTX-M-15 enzyme genes by polymerase chain reaction (PCR). PCR products were sent to Shanghai bioworkers for gene sequencing. Results the drug resistance patterns of 71 strains of Escherichia coli were multidrug resistance 30 strains, double resistance 19 strains, single resistance 16 strains, and total sensitivity 6 strains, accounting for 42.2% 26.822.5% and 8.5% respectively. 56 strains of multidrug resistant Escherichia coli were resistant to imipenem and amikacin. The resistance rates to cefotaxime, aztreonam and gentamicin were 50.0. Of 56 strains of multidrug resistant Escherichia coli, 44 strains were detected CTXM-14 enzyme gene, 28 strains were detected CTX-M-15 enzyme gene, the detection rate was 78.6% and 50.0%, respectively. The resistance rates of multidrug resistant Escherichia coli and ceftazidime to cefotaxime and ceftazidime were 81.82.2% and 96.4%, respectively. The difference was statistically significant (P0.01). Conclusion CTX-M-14 and CTX-M-15 genes are common in multidrug resistant Escherichia coli. The resistance rate of multidrug resistant Escherichia coli carrying CTX-M-14 and CTX-M-15 enzyme gene to cefotaxime is higher than that of ceftazidime.
【作者单位】：西南医科大学附属医院;
【基金】：四川省重点学科重点建设基金资助项目(SZD0421)
【分类号】：R440

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