[1]徐学静,曹小利,张之烽,等.血培养大肠埃希菌的药物敏感性分析及ESBLs编码基因的流行性分析[J].现代检验医学杂志,2016,31(01):55-57.[doi:10.3969/j.issn.1671-7414.2016.01.015]
　XU Xue-jing,CAO Xiao-li,ZHANG Zhi-feng,et al.Analysis on the Antimicrobial Susceptibilities and the Prevalenceof ESBLs Encoding Genes of Escherichia Coli Isolates Collected from Blood[J].Journal of Modern Laboratory Medicine,2016,31(01):55-57.[doi:10.3969/j.issn.1671-7414.2016.01.015]
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血培养大肠埃希菌的药物敏感性分析及ESBLs编码基因的流行性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年01期
页码:
55-57
栏目:
论著
出版日期:
2016-01-25

文章信息/Info

Title:
Analysis on the Antimicrobial Susceptibilities and the Prevalenceof ESBLs Encoding Genes of Escherichia Coli Isolates Collected from Blood
作者:
徐学静; 曹小利; 张之烽; 宁明哲; 周万青; 张 葵; 沈 瀚
南京大学医学院附属鼓楼医院检验科,南京 210008
Author(s):
XU Xue-jing; CAO Xiao-li; ZHANG Zhi-feng; NING Ming-zhe; ZHOU Wan-qing;  ZHANG Kui; SHEN Han
Department of Medical Laboratory,the Affiliated Drum Tower Hospital of Medical School,Nanjing University,Nanjing 210008,China
关键词:
大肠埃希菌;  超广谱β-内酰胺酶;  血培养;  耐药性;  敏感性
分类号:
R378.21; Q503
DOI:
10.3969/j.issn.1671-7414.2016.01.015
文献标志码:
A
摘要:
目的 对2012年血培养分离121株大肠埃希菌的药物敏感性、产ESBLs情况及ESBLs编码基因blaCTX-M,blaTEM和blaSHV的分布进行分析。方法 收集2012年血培养非重复分离大肠埃希菌121株,使用WHONET 5.6分析耐药性; 采用双纸片协同法确认试验筛选产ESBLs菌; 聚合酶链反应(PCR)法和DNA测序法分析产ESBLs菌中blaCTX-M,blaTEMt blaSHV基因的流行性。结果 121株大肠埃希菌对广谱青霉素和二,三代头孢菌素、左旋氧氟沙星及复方新诺明都有较高的耐药性,耐药率大于40%; 对亚胺培南、哌拉西林/他唑巴坦、阿米卡星有较高的敏感性,耐药率小于12%; 121株大肠埃希菌中,86(88.7%)株产ESBLs,blaCTX-M,blaTEM和blaSHV基因的检出率分别为59.5%(72),38.8%(47)及4.1%(5)株; 其中,2(1.7%)株细菌同时携带blaCTX,blaTEM和blaSHV基因,30(24.8%)株细菌同时携带blaCTX和blaTEM基因,1(0.8%)株细菌同时携带blaSHV和blaTEM基因。结论 南京鼓楼医院血培养大肠埃希菌大多产ESBLs,以bla(CTX-M-14)的流行为主,对大多数的青霉素类、头孢菌素和单环类等常用抗菌药物耐药治疗时应根据药敏结果选择抗菌药物。
Abstract:
Objective To analyze the susceptibilities of Escherichia coli isolates collected from blood and the prevalence of ESBLs encoding genes.Methods A total of 121 Escherichia coliisolates collected from blood during 2012 were analyzed for antimicrobial susceptibilities by software of WHONET 5.6,the production of ESBLs was confirmed byconfirmatory phenotypic testing,PCR and DNA sequence were further implemented to analyze the ESBLs-encoding genes.Results 121 E.coli isolates displayed high resistance towards broad spectrum penicillin and 2ndor 3rd generation cephalosporins,levofloxacin and cotrimoxazole,with the resistance rates being more than 40%,susceptibilities to imipenem,piperacillin/tazobactam,amikacin were observed,with the resistance rates to be less than 12%,86(88.7%)out of 121 isolates were found to produce ESBLs.Among them,59.5%(72),38.8%(47)and 4.1%(5)were confirmed to carry blaCTX-M,blaTEM and blaSHV genes.Additionally,2(1.7%)isolates carried all the genes detected,30(24.8%)isolates carried both of blaCTX and blaTEM,1(0.8%)isolate carried bothof blaSHV andblaTEM.Conclusion Most of the E.coli isolates from the blood culture in Nanjing Gulou Hospital produce ESBLs,and displayed resistance towards most of the penicillins,cephalosporins and single amide antimicrobial agents should be chosen according to susceptibility results.

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备注/Memo

备注/Memo:
基金项目:南京市卫生局医学科技发展资金资助(QRX11191)。 作者简介:徐学静(1983-),女,主管技师,主要从事临床检验工作,Tel:13951829953,E-mail:xxuejing@hotmail.com。 通讯作者:沈 瀚,男,主任技师,E-mail:shenhan10366@sina.com。
更新日期/Last Update: 2016-01-20