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目的调查耐药大肠埃希菌中可移动耐药元件(可移动遗传元件遗传标记与耐药基因)的携带情况,为临床治疗提供参考依据。方法收集医院2015年1-12月住院患者痰液标本中分离的耐药大肠埃希菌共32株,采用聚合酶链反应(PCR)及序列分析的方法分析3种可移动遗传元件与16种β-内酰胺类耐药基因并对结果进行了样本聚类分析,以了解菌株的亲缘关系。结果 32株耐药大肠埃希菌共检出1种可移动遗传元件遗传标记intⅠ1共27株(84.4%);β-内酰胺类耐药基因总检出率为100.0%,共检出4种阳性基因:blaTEM、blaSHV、blaCTX-M-群、blaOXA-1群;氨基糖苷类耐药基因总检出率为93.8%,共检出5种阳性基因:aac(3)-Ⅱ、aac(6′)-Ⅰb、ant(3″)-Ⅰ、ant(2″)-Ⅰ、aph(3′)-Ⅰ。结论耐药大肠埃希菌检出的可移动耐药元件是导致对β-内酰胺类、氨基糖苷类、磺胺甲噁唑/甲氧苄啶耐药的重要原因,并且耐药表型和基因型一一对应;本组菌中三个不同的克隆有医院感染的可能。
Objective To investigate the carriage of mobile drug-resistant elements (genetic markers and resistance genes of mobile genetic elements) in drug-resistant Escherichia coli and to provide a reference for clinical treatment. Methods A total of 32 strains of drug-resistant Escherichia coli isolated from the sputum samples of hospitalized patients from January to December 2015 in our hospital were collected. Polymerase chain reaction (PCR) and sequence analysis were used to analyze three kinds of mobile genetic elements and 16 β-lactam resistance genes and the results of cluster analysis of samples to understand the genetic relationship of strains. Results A total of 27 markers (84.4%) were detected in 32 strains of resistant Escherichia coli with a genetic marker of intI1. The total detection rate of β-lactam resistant genes was 100.0%. A total of 4 The positive genes were blaTEM, blaSHV, blaCTX-M-group and blaOXA-1 group. The total detection rate of aminoglycoside resistance gene was 93.8% .A total of 5 positive genes were identified as aac (3) ’) - Ⅰb, ant (3 “) - Ⅰ, ant (2”) - Ⅰ, aph (3’) - Ⅰ. Conclusions The mobile drug-resistant elements detected by drug-resistant Escherichia coli are the important reasons leading to the resistance to β-lactams, aminoglycosides and sulfamethoxazole / trimethoprim. The resistant phenotypes and genes One correspondence; three different clones in this group of bacteria may have nosocomial infections.