新生儿粪便产超广谱β-内酰胺酶菌基因及耐药性分析

发布时间：2018-02-24 18:09

本文关键词： 粪便产超广谱β-内酰胺酶菌基因耐药性新生儿　出处：《临床儿科杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨新生儿粪便中产超广谱β-内酰胺酶(ESBL)菌产生途径,了解新生儿肠道产ESBL菌基因及耐药性。方法收集医院出生的健康新生儿及其母亲的粪便样本,应用选择性ESBL培养基进行细菌培养;培养阳性菌株应用飞行时间质谱仪进行菌种鉴定;全基因组测序技术进行ESBL基因型和耐药基因检测。结果 146份新生儿粪便标本,产ESBL菌阳性检出率8.90%,其中第1次排便产ESBL菌阳性检出率3.23%;出生72 h后粪便产ESBL菌阳性检出率为13.10%;13株产ESBL菌中CTX型9株,TEM型3株,SHV型1株;9株CTX型包括CTX-M-24、CTX-M-18、CTX-M-27、CTX-M-42和CTX-M-15五种型别。167份母亲粪便标本,产ESBL菌阳性检出率21.6%;ESBL基因型包括CTX型24株,TEM型6株,SHV型4株,Qnr S型2株;24株CTX型包括CTX-M-24、CTX-M-14、CTX-M-18、CTX-M-27、CTX-M-42和CTX-M-15。母婴共有12份标本检出2种或3种ESBL基因型。母婴49株产ESBL菌共检出aad A5、str A、str B、sul1、sul2和dfr A17等6种耐药基因;母婴同时检出产ESBL菌者,其耐药基因完全一致;7例新生儿和23例母亲粪便检出多种耐药基因。结论住院分娩新生儿在院期间可与母亲同时或单独在肠道检出产ESBL菌;新生儿肠道产ESBL菌产生途径有多种;产ESBL菌基因型和耐药基因种类较多。
[Abstract]:Objective to explore the pathway of producing extended-spectrum 尾 -lactamase (ESBL-) bacteria in neonatal feces, and to understand the genes and drug resistance of neonatal enterogenic bacteria. Methods fecal samples of healthy newborns born in hospitals and their mothers were collected. The bacteria were cultured on selective ESBL medium, the positive strains were identified by time-of-flight mass spectrometer, and the ESBL genotypes and drug-resistant genes were detected by whole genome sequencing. The positive rate of ESBL producing bacteria was 8.90, the positive rate of ESBL producing bacteria was 3.23 in the first defecation, the positive rate of ESBL producing bacteria in feces after 72 hours was 13.101010 and 13 ESBL producing strains, CTX 9, Tem 3, SHV 1, CTX 1, including CTX-M-24CTX-18CTX-M-27CTX-M-42 and CTX-M-15, five kinds of ESBL producing bacteria, including CTX-M-24CTX-18CTX-M-27CTX-M-42 and CTX-M-15. Type. 167 faecal specimens from mothers, The positive rate of ESBL producing bacteria was 21.6% including 24 strains of CTX type, 6 strains of TEM type, 6 strains of SHV type, 4 strains of Qnr S type, 2 strains of CTX type including CTX-M-24, CTX-M-14, CTX-M-18, CTX-M-27, CTX-M-42 and CTX-M-15. Two or three ESBL genotypes were detected in 12 samples, and 49 strains of ESBL strains were detected. Aad A5, str, str, Bsul1sul2 and dfr A17, etc. Multidrug resistance genes were detected in the feces of 7 newborns and 23 mothers at the same time. Conclusion ESBL producing bacteria can be detected at the same time or only in the intestines of the newborns born in hospital. There are many ways of producing ESBL bacteria in the intestinal tract of newborns, and there are many genotypes and drug resistant genes of ESBL producing bacteria.
【作者单位】：长春市儿童医院;林雪平大学;长春市妇产科医院;
【分类号】：R446.5;R722.1

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