5株携带blaNDM-5基因大肠埃希菌临床株的分子流行特征分析

发布时间：2018-12-27 14:30

【摘要】：目的探讨耐碳青霉烯类抗菌药物大肠埃希菌的耐药机制并对分离株的分子流行特征进行分析,为医院感染的防控提供依据。方法选取2015年5月-2016年10月住院患者标本分离的5株耐碳青霉烯类抗菌药物的大肠埃希菌,产金属碳青霉烯酶的筛选采用亚胺培南/EDTA复合E-test条,采用PCR方法检测菌株携带的碳青霉烯酶、超广谱β-内酰胺酶、ampC酶和喹诺酮类耐药相关基因,并测序确认类型及其亚型,脉冲场凝胶电泳技术检测分离株间的同源性,液相质粒接合试验分析质粒的转移特性。结果除了阿米卡星和氨曲南外,5株大肠埃希菌对目前测试的头孢菌素、碳青霉烯类和喹诺酮类抗菌药物都耐药,且金属酶表型实验结果都呈现阳性;5株大肠埃希菌携带不同的耐药基因,但都携带blaNDM-5和blaTEM-1基因;脉冲场凝胶电泳显示5株大肠埃希菌的脉冲带型不一致,没有呈现克隆聚集性;质粒接合试验没有显示5株大肠埃希菌临床株(供体菌)将携带blaNDM-5的质粒转移到大肠埃希菌J53AziR(受体菌)。结论研究结果表明本地区存在携带blaNDM-5基因的大肠埃希菌的流行,但没有呈现克隆聚集暴发性,为预防和控制医院感染的暴发,必须重视和加强对耐碳青霉烯类抗菌药物肠杆菌的监测。
[Abstract]:Objective to investigate the mechanism of resistance to carbapenem antibiotics Escherichia coli and analyze the molecular epidemiological characteristics of the isolates so as to provide evidence for the prevention and control of nosocomial infection. Methods five strains of Escherichia coli resistant to carbapenem were isolated from hospitalized patients from May 2015 to October 2016. Imipenem / EDTA compound E-test was used for screening metal carbapenem producing enzyme. The genes related to carbapenem, extended-spectrum 尾 -lactamases, ampC and quinolone resistance were detected by PCR, and the types and subtypes were confirmed by sequencing. The homology of the isolates was detected by pulsed field gel electrophoresis (PGE). Liquid phase plasmids binding test was used to analyze the transfer characteristics of plasmids. Results in addition to amikacin and aztreonam, 5 strains of Escherichia coli were resistant to cephalosporins, carbapenems and quinolones, and the results of metallozyme phenotypic tests were all positive. Five strains of Escherichia coli carried different drug resistance genes, but all of them carried blaNDM-5 and blaTEM-1 genes, and pulsed field gel electrophoresis showed that the pulse-band patterns of 5 strains of Escherichia coli were not consistent and showed no clonal aggregation. Plasmid conjugation test did not show that 5 clinical strains of Escherichia coli (donor) transferred plasmid carrying blaNDM-5 to Escherichia coli J53AziR (recipient bacteria). Conclusion the results show that there is an epidemic of Escherichia coli carrying blaNDM-5 gene in this area, but it does not present a fulminant clone aggregation, in order to prevent and control the outbreak of nosocomial infection. We must pay attention to and strengthen the monitoring of carbapenem-resistant antibiotics Enterobacter.
【作者单位】：山东省滕州市中心人民医院检验科;青岛大学附属医院检验科;山东烟台业达医院检验科;青岛大学医学院检验系;
【基金】：山东省科技发展计划基金资助项目(GG201703260063) 青岛开发区重点科技发展基金资助项目(2013-1-82)
【分类号】：R446.5

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