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目的研究CTX-M型超广谱β内酰胺酶(ESBLs)及Ⅰ类整合子在耐三代头孢菌素阴沟肠杆菌中的分布,进一步探讨Ⅰ类整合子与CTX-M型ESBLs的关系。方法运用K-B法检测阴沟肠杆菌临床株的耐药表型,双纸片协同试验(DDST)初筛产ESBLs的菌株,聚合酶链反应(PCR)扩增确证产CTX-M型ESBLs和含有Ⅰ类整合子的临床菌株,套式PCR及序列测定寻找携带CTX-M型ESBLs基因盒的Ⅰ类整合子。结果37株耐药菌中,21株菌产生CTX-M型ESBLs;20株菌含有Ⅰ类整合子;在13株同时产生Ⅰ类整合子和CTX-M型ESBLs的临床株中,3株菌CH4、CH11和Q1的CTX-M型ESBLs基因盒分布在Ⅰ类整合子上。结论Ⅰ类整合子的存在增加了ESBLs在临床株中水平播散的危险,是造成多重耐药株在院内暴发流行的重要原因。
Objective To investigate the distribution of CTX-M ESBLs and class I integrons in third generation cephalosporins of Enterobacter cloacae, and to further explore the relationship between type I integrons and CTX-M type ESBLs. Methods The resistant phenotypes of clinical strains of Enterobacter cloacae were detected by KB method. ESBLs-producing strains were screened by DDST in duplicate. The CTX-M type ESBLs were confirmed by polymerase chain reaction (PCR) CLASS INTEGRATOR CLINICAL STRAINS, NACLEAR PCR AND SEQUENCY ASSAYS Find class I integrants that carry the CTX-M type ESBLs gene cassette. Results Of the 37 resistant strains, 21 strains produced CTX-M type ESBLs; 20 strains contained class Ⅰ integron; among the 13 clinical isolates that produced both class Ⅰ integron and CTX-M type ESBLs, 3 strains of bacteria The CTX-M type ESBLs gene cassettes of CH4, CH11 and Q1 are distributed on the class I integron. Conclusion The presence of class I integron increases the risk of ESBLs spreading in clinical strains and is an important reason for the outbreak of multi-resistant strains in the hospital.