论文部分内容阅读
目的系统评价大肠埃希菌产质粒介导AmpC酶基因在中国的分布情况。方法检索四个中文数据库、EMbase、PubMed及外文期刊数据库,检索时间为建库至2015年5月,由2名独立的研究者严格按照纳入和排除标准筛选文献、提取相关数据,对筛选到的大肠埃希菌ESBLs基因的研究文献,采用Stata 12.1软件进行单组率的Meta分析,分析内容包括大肠埃希菌质粒介导AmpC酶各类基因的检出率和不同地区的分布差异。结果共纳入35篇中文文献和4篇外文文献,采用随机效应模式进行数据分析,合并结果显示:(1)中国大肠埃希菌质粒介导AmpC酶基因的阳性率为5.0%(95%CI:4.0%-7.0%)、2005-2008年大肠埃希菌质粒介导AmpC酶基因的阳性率为5.0%(95%CI:3.0%-7.0%)、2009-2013年大肠埃希菌质粒介导AmpC酶基因的阳性率为6.0%(95%CI:4.0%-8.0%),两个时间段AmpC酶基因阳性率的差异具有统计学意义(P<0.05);(2)DHA型引物扩增基因的检出率为43.0%(95%CI:28.0%-59.0%)、CIT型引物扩增基因的检出率为52.0%(95%CI:37.0%-66.0%)、EBC型引物扩增基因的检出率为23.0%(95%CI:10.0%-37.0%);(3)北方地区大肠埃希菌质粒介导AmpC酶基因的阳性率为8.0%(95%CI:5.0%-11.0%)、东南地区大肠埃希菌质粒介导AmpC酶基因的阳性率为5.0%(95%CI:1.0%-9.0%)、中西部地区大肠埃希菌质粒介导AmpC酶基因的阳性率为6.0%(95%CI:2.0%-10.0%)、长江三角洲地区大肠埃希菌质粒介导AmpC酶基因的阳性率为7.0%(95%CI:4.0%-9.0%),经χ2检验,四个地区质粒介导AmpC酶基因的阳性率差异具有统计学意义(P<0.05)。结论大肠埃希菌质粒介导AmpC酶基因在中国以CIT型引物扩增基因的检出率最高,且主要为CMY-2基因;2009-2013年时段AmpC酶基因阳性率高于2005-2008年时段,差异具有统计学意义(P<0.05);中国四个地区大肠埃希菌质粒介导AmpC酶基因的阳性率差异具有统计学意义(P<0.05)。
Objective To evaluate the distribution of AmpC gene mediated by Escherichia coli producing plasmid in China. Methods The databases of four Chinese databases, EMbase, PubMed and foreign language periodicals were retrieved. The search time was from the establishment of the database to May 2015. Two independent researchers screened the documents strictly in accordance with inclusion and exclusion criteria and extracted the relevant data. The Escherichia coli ESBLs gene research literature, using Stata12.1 software for single-rate Meta analysis, including the analysis of Escherichia coli plasmid-mediated AmpC enzyme detection rate of various genes and distribution differences in different regions. Results A total of 35 Chinese articles and 4 foreign articles were included in this study. Data were analyzed using a random effect model. The pooled results showed that: (1) The positive rate of Escherichia coli-mediated AmpC gene was 5.0% (95% CI: 4.0% -7.0%). The positive rate of Escherichia coli plasmid-mediated AmpC gene was 5.0% (95% CI: 3.0% -7.0%) in 2005-2008. The positive rate of Escherichia coli plasmid mediated The positive rate of AmpC gene was 6.0% (95% CI: 4.0% -8.0%). The positive rate of AmpC gene in two time periods was statistically significant (P <0.05). (2) The detection rate of the gene was 43.0% (95% CI: 28.0% -59.0%), the detection rate of CIT primer amplification gene was 52.0% (95% CI: 37.0% -66.0%), the amplification of EBC primer (95% CI: 10.0% -37.0%); (3) The positive rate of Escherichia coli plasmid-mediated AmpC gene was 8.0% (95% CI: 5.0% -11.0 %). The positive rate of Escherichia coli plasmid-mediated AmpC gene in the southeast region was 5.0% (95% CI: 1.0% -9.0%). The positive rate of Escherichia coli-mediated AmpC gene in the central and western regions was 6.0% (95% CI: 2.0% -10.0%). The Escherichia coli-mediated AmpC enzyme gene in the Yangtze River Delta The positive rate of 7.0% (95% CI: 4.0% -9.0%), by the χ2 test, four regions of plasmid-mediated AmpC gene positive rate is statistically significant (P <0.05). Conclusion The positive rate of AmpC gene mediated by Escherichia coli is highest in China with CIT primers and the majority is CMY-2 gene. The positive rate of AmpC gene in 2009-2013 is higher than that in 2005-2008 (P <0.05). There were significant differences in the positive rate of AmpC gene mediated by Escherichia coli among the four regions in China (P <0.05).