某医院大肠埃希菌产ESBLs菌株耐药性及基因型分析
发布时间：2018-11-13 14:00
【摘要】：目的了解某医院近3年来产超广谱β-内酰胺酶(extended spectrumβ-lactamases,ESBLs)大肠埃希菌感染分布以及耐药性变化,检测ESBLs基因型,为临床合理治疗大肠埃希菌感染提供依据。方法收集某院2014年1月~2016年10月从临床各类标本中分离培养鉴定的316株大肠埃希菌,采用梅里埃VITEK 2 COMPACT全自动细菌分析仪进行药物敏感试验并筛选ESBLs菌株,初筛ESBLs阳性菌株进一步采用双纸片琼脂扩散法进行确认。采用PCR技术分别检测产ESBLs菌株的CTX-M、TEM、SHV和OXA基因型。结果(1)产ESBLs大肠埃希菌的检出率为41.5%(131/316),检出率较高的标本为分泌物和尿液(47.5%和45.8%),不同标本之间ESBLs菌株的检出率无显著性差异(P0.05);2014年、2015年和2016年ESBLs菌株的检出率分别为44.8%(43/96)、39.6%(44/111)和40.4%(44/109),亦无显著性差异(P0.05)。(2)大肠埃希菌对青霉素类、喹诺酮类和部分头孢菌素类等抗菌药物耐药率较高(47.7%~81.4%),而其中产ESBLs菌株对这些药物的耐药率高达67.9%~100%,大肠埃希菌对阿米卡星、厄他培南、哌拉西林/他唑巴坦、头孢替坦和亚胺培南的耐药率低于5%。产ESBLs菌株对多数抗菌药物的耐药率高于非产ESBLs的菌株,差异有显著性(P0.05)。不同年份之间大肠埃希菌及产ESBLs菌株耐药率有一定差异,但差异不明显。(3)43株产ESBLs菌株有24株携带CTX-M基因,占55.8%;2株携带TEM基因,占7.0%,未扩增出SHV基因和OXA基因。结论(1)该院各类标本来源大肠埃希菌均可检测到ESBLs菌株,近3年检出率无明显变化。(2)大肠埃希菌对多种抗菌药物产生耐药性,产ESBLs菌株耐药现象更为严重,临床应加强病原菌检测,依据药敏结果合理选择抗菌药物。(3)该院大肠埃希菌ESBLs基因型以CTX-M为主。
[Abstract]:Objective to investigate the distribution and drug resistance of extended-spectrum 尾 -lactamase (extended spectrum 尾-lactamases,ESBLs) Escherichia coli in a hospital in recent three years, and to detect the genotype of ESBLs in order to provide evidence for clinical treatment of Escherichia coli infection. Methods from January 2014 to October 2016, 316 strains of Escherichia coli were isolated and identified from clinical specimens. Merier VITEK 2 COMPACT automatic bacterial analyzer was used for drug sensitivity test and screening of ESBLs strains. ESBLs positive strains were further identified by double disk Agar diffusion method. CTX-M,TEM,SHV and OXA genotypes of ESBLs producing strains were detected by PCR. Results (1) the positive rate of ESBLs producing Escherichia coli was 41.5% (131 / 316), and the higher detection rate was secretion and urine (47.5% and 45.8%). There was no significant difference in the detection rate of ESBLs among different specimens (P0.05). The detection rates of ESBLs strains in 2014, 2015 and 2016 were 44.8% (43 / 96), 39.6% (44 / 111) and 40.4% (44 / 109), respectively. There was no significant difference (P0.05). (2) between Escherichia coli and penicillin. The resistance rate of quinolones and some cephalosporins was higher (47.7%, 81.4%), and the resistance rate of ESBLs producing strains to these drugs was as high as 67.9%, and Escherichia coli was resistant to amikacin and ertapenem. The resistance rates of piperacillin / tazobactam, ceftitan and imipenem were lower than 5%. The resistance rate of ESBLs producing strains to most antimicrobial agents was higher than that of non-ESBLs producing strains (P0.05). There were some differences in drug resistance of Escherichia coli and ESBLs producing strains between different years, but the difference was not obvious. (3) 24 strains of 43 ESBLs producing strains carried CTX-M gene, accounting for 55.8%; The two strains carried TEM gene, accounting for 7.0%, and no SHV gene and OXA gene were amplified. Conclusion (1) Escherichia coli from all kinds of specimens in our hospital can be detected with ESBLs strain, and the detection rate of Escherichia coli has no obvious change in the past three years. (2) Escherichia coli is resistant to many kinds of antimicrobial agents, and the drug resistance of ESBLs producing strain is more serious. Clinical examination of pathogenic bacteria should be strengthened and antibiotics should be reasonably selected according to the results of drug sensitivity. (3) the ESBLs genotype of Escherichia coli in our hospital was mainly CTX-M.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R446.5
[Abstract]:Objective to investigate the distribution and drug resistance of extended-spectrum 尾 -lactamase (extended spectrum 尾-lactamases,ESBLs) Escherichia coli in a hospital in recent three years, and to detect the genotype of ESBLs in order to provide evidence for clinical treatment of Escherichia coli infection. Methods from January 2014 to October 2016, 316 strains of Escherichia coli were isolated and identified from clinical specimens. Merier VITEK 2 COMPACT automatic bacterial analyzer was used for drug sensitivity test and screening of ESBLs strains. ESBLs positive strains were further identified by double disk Agar diffusion method. CTX-M,TEM,SHV and OXA genotypes of ESBLs producing strains were detected by PCR. Results (1) the positive rate of ESBLs producing Escherichia coli was 41.5% (131 / 316), and the higher detection rate was secretion and urine (47.5% and 45.8%). There was no significant difference in the detection rate of ESBLs among different specimens (P0.05). The detection rates of ESBLs strains in 2014, 2015 and 2016 were 44.8% (43 / 96), 39.6% (44 / 111) and 40.4% (44 / 109), respectively. There was no significant difference (P0.05). (2) between Escherichia coli and penicillin. The resistance rate of quinolones and some cephalosporins was higher (47.7%, 81.4%), and the resistance rate of ESBLs producing strains to these drugs was as high as 67.9%, and Escherichia coli was resistant to amikacin and ertapenem. The resistance rates of piperacillin / tazobactam, ceftitan and imipenem were lower than 5%. The resistance rate of ESBLs producing strains to most antimicrobial agents was higher than that of non-ESBLs producing strains (P0.05). There were some differences in drug resistance of Escherichia coli and ESBLs producing strains between different years, but the difference was not obvious. (3) 24 strains of 43 ESBLs producing strains carried CTX-M gene, accounting for 55.8%; The two strains carried TEM gene, accounting for 7.0%, and no SHV gene and OXA gene were amplified. Conclusion (1) Escherichia coli from all kinds of specimens in our hospital can be detected with ESBLs strain, and the detection rate of Escherichia coli has no obvious change in the past three years. (2) Escherichia coli is resistant to many kinds of antimicrobial agents, and the drug resistance of ESBLs producing strain is more serious. Clinical examination of pathogenic bacteria should be strengthened and antibiotics should be reasonably selected according to the results of drug sensitivity. (3) the ESBLs genotype of Escherichia coli in our hospital was mainly CTX-M.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R446.5
【参考文献】
相关期刊论文 前10条
1 罗文英;丁瑜;林湛;许蓝月;;95株致泌尿道感染大肠埃希菌耐药性及耐药基因表型分析[J];检验医学与临床;2016年21期
2 徐非凡;钱旭琴;刘艳;;医院获得性肺炎病原菌分布及主要致病菌流行特点[J];中国病原生物学杂志;2016年10期
3 夏浩海;王学敏;;某县级医院2012—2014年不同临床标本分离大肠埃希菌ESBLs检出率及其耐药性[J];中国感染控制杂志;2016年05期
4 招钜泉;马均宝;刘红军;;超广谱β-内酰胺酶基因分型特点及其对抗生素敏感性分析[J];中国药物经济学;2016年05期
5 蒋鸿超;奎莉越;黄海林;苏敏;樊茂;王爱萍;;儿童感染的志贺菌Ⅰ类整合子表达及其与产超广谱β-内酰胺酶基因关系的研究[J];儿科药学杂志;2016年02期
6 ;2014年全国细菌耐药监测报告[J];中国执业药师;2016年02期
7 杨君;凌宙贵;刘卫;蒋连强;唐贞明;;医院重点科室住院患者产ESBLs大肠埃希菌及耐药性动态监测结果分析[J];内科;2015年05期
8 张雪冬;朱光发;王爱萍;;产ESBLs大肠埃希菌的分布及耐药性分析[J];临床肺科杂志;2015年06期
9 陈中举;汪s，
本文编号：2329351
本文链接：https://www.wllwen.com/kejilunwen/jiyingongcheng/2329351.html
最近更新
教材专著
