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目的研究深圳龙华地区餐饮业从业人员携带大肠埃希菌对β-内酰胺类药物的耐药性,为该类人群的卫生细菌学检查提供依据。方法采用纸片法检测大肠埃希菌的药物敏感性;采用双纸片扩散法检测β-内酰胺类药物耐药菌株的超广谱β-内酰胺酶(ESBLs);采用PCR法检测β-内酰胺类药物耐药菌株ESBLs基因(TEM、SHV、OXA、CTX)。采用PCR法检测大肠埃希菌Ⅰ类整合子整合酶基因及其耐药基因盒。结果 108株大肠埃希菌对9种β-内酰胺类药物的耐药率从高到低依次为:氨苄西林87.0%、阿莫西林/棒酸60.2%、头孢呋辛59.3%、头孢唑林50.9%、头孢曲松36.1%、头孢他啶34.3%、头孢西丁31.5%、头孢吡肟16.7%、亚胺培南11.1%;其中61.1%(66/108)株菌对2种及2种以上β-内酰胺类药物耐药。在β-内酰胺类药物耐药株中,产ESBLs株的检出率为37.9%(25/66),其中产ESBLs菌对头孢呋辛、头孢吡肟、头孢曲松和头孢唑啉的耐药率与非产ESBLs菌的耐药率存在显著差异(均P<0.01);ESBLs基因的检出率为72.7%(48/66),其中,携带TEM基因的为11株、SHV17株、CTX13株、OXA11株;有的菌株同时携带SHV和CTX,或TEM和CTX,或OXA和CTX2种基因。大肠埃希菌Ⅰ类整合酶基因检出率54.6%(59/108);Ⅰ类整合子阳性菌株中耐药基因盒检出率79.7%(47/59),其中超广谱β-内酰胺酶基因CTX-M、OXA占32.2%(19/59)。结论深圳龙华地区餐饮业从业人员携带的大肠埃希菌对β-内酰胺类药物的耐药率较高,其耐药性与ESBLs产生及ESBLs基因密切相关;该类基因易在细菌间传播,故餐饮业从业人员携带的大肠埃希菌耐药性监测值得重视。
Objective To study the resistance of Escherichia coli to β-lactam in the restaurant industry in Longhua, Shenzhen, and to provide the basis for the hygienic bacteriological examination of this population. Methods The drug susceptibility of Escherichia coli was detected by disk method. Extended-spectrum β-lactamases (ESBLs) of β-lactam drug-resistant strains were detected by double disk diffusion method. The β- Lactam drug-resistant strains of ESBLs genes (TEM, SHV, OXA, CTX). The Escherichia coli Class Ⅰ integron gene and its drug resistance gene cassette were detected by PCR. Results The resistance rates of 108 strains of Escherichia coli to 9 kinds of β-lactam drugs were as follows: ampicillin 87.0%, amoxicillin / clavulanic acid 60.2%, cefuroxime 59.3%, cefazolin 50.9%, ceftriaxone 36.1%, ceftazidime 34.3%, cefoxitin 31.5%, cefepime 16.7% and imipenem 11.1%, of which 61.1% (66/108) strains against 2 and more than 2 - Lactam drug resistance. In the β-lactam drug-resistant strains, the detection rate of ESBLs-producing strains was 37.9% (25/66). The ESBLs producing strains were resistant to cefuroxime, cefepime, ceftriaxone and cefazolin The rates of ESBLs-producing bacteria were significantly different (all P <0.01). The detection rate of ESBLs was 72.7% (48/66), of which 11 were TEM genes, Strains, OXA11 strains; some strains carrying both SHV and CTX, or TEM and CTX, or OXA and CTX2 kinds of genes. The detection rate of type Ⅰ integrase gene of Escherichia coli was 54.6% (59/108). The positive rate of drug-resistant gene cassette in class Ⅰ integron was 79.7% (47/59) Enzyme gene CTX-M, OXA accounted for 32.2% (19/59). Conclusion The resistance rate of Escherichia coli carrying β-lactam in Escherichia coli of catering industry practitioners in Longhua, Shenzhen is high, and the drug resistance is closely related to the production of ESBLs and ESBLs genes. The genes are easy to spread among bacteria, Therefore, food and beverage industry practitioners carrying E. coli resistance monitoring deserves attention.