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目的分析云南某医院E.coli和K.pneumonia菌耐药基因分子流行病学特征。方法全自动微生物分析仪分类鉴定菌株及抗生素敏感试验。扩增并序列分析耐药基因。MLST及PFGE分析菌株遗传变异关系。结果共收集23株E.coli菌和9株K.pneumonia菌,除了1株XDR K.pneumoniae,其余均为MDR菌。全部菌株对一代、二代头孢霉素,甚至三代头孢霉素CRO耐药。绝大多数菌株对氟化奎林酮类、氨基苷类及磺胺类抗生素耐药。39.1%和69.6%E.coli携带blaTEM和blaCTX基因,而44.4%和100.0%K.pneumoniae检测到blaTEM和blaCTX基因。bla TEM均为TEM-1基因型。CTX-M-55及CTX-M-15为该地区优势基因型。所有K.pneumonia菌株携带blaSHV基因,SHV-11为优势型。87.5%E.coli和77.8%K.pneumoniae菌株携带ISEcp1。91.3%E.coli和77.8%K.pneumoniae携带int1。44.4%K.pneumoniae携带ISCR1基因。PFGE及MLST研究显示菌株存在明显的遗传多态性。结论云南该医院多重耐药E.coli和K.pneumonia菌呈高度流行,耐药基因在不同菌株及菌种间快速传播。
Objective To analyze the molecular epidemiology of drug resistance genes of E.coli and K.pneumonia in a hospital in Yunnan Province. Methods Automatic microorganism analyzer classification identification strains and antibiotic sensitivity test. Amplify and sequence analysis of drug resistance genes. MLST and PFGE analysis of genetic variation of strains. Results A total of 23 strains of E.coli and 9 strains of K.pneumonia were collected, except for one strain of XDR K.pneumoniae, the others were MDR. All strains of the generation, second generation cephalosporins, and even third generation cephalosporins CRO resistance. The vast majority of strains of fluoroquinolones, aminosides and sulfa antibiotics. The blaTEM and blaCTX genes were carried in 39.1% and 69.6% of E. coli, while blaTEM and blaCTX genes were detected in 44.4% and 100.0% of K. pneumoniae. bla TEM are all TEM-1 genotypes. CTX-M-55 and CTX-M-15 are the dominant genotypes in the region. All K. pneumoniae strains carry the blaSHV gene, and SHV-11 is dominant. 87.5% E. coli and 77.8% K. pneumoniae strains harboring ISEcp 1.91.3% E. coli and 77.8% K. pneumoniae carrying int 1.44.4% K. pneumoniae carrying the ISCR1 gene. PFGE and MLST studies have shown that the strains have obvious genetic polymorphisms. Conclusion The multi-drug resistant strains of E.coli and K.pneumonia in Yunnan are highly epidemic, and the resistant genes spread rapidly among different strains and strains.