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目的:了解我院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的耐药基因型别分布及耐药性分析,为临床合理使用抗菌药物提供参考依据。方法:收集我院2014年临床细菌培养标本分离的产ESBLs大肠埃希菌68株,采用聚合酶链反应(PCR)法及测序分析确定耐药基因型别。通过最小抑菌浓度(MIC)法测定大肠埃希菌对抗菌药物的耐药性,与同期75株ESBL(-)的大肠埃希菌做比较分析。结果:68株ESBLs(+)的大肠埃希菌检出耐药基因型以CTX-M型、TEM-1型、CTX-M型多见,检出同一菌株携带两种CTX-M亚型基因型,未检测出SHV型。产ESBLs大肠埃希菌对氨曲南、左氧氟沙星、复方新诺明、环丙沙星、头孢唑啉、头孢曲松的耐药率均达70%以上。耐药率均高于ESBL(-)的大肠埃希菌。结论:我院产ESBLs大肠埃希菌ESBLs基因以CTX-M型为主,CTX-M型亚型以CTX-M-14、CTX-M-15型为主,与我国其他地区耐药基因型存在差异。产ESBLs大肠埃希菌对头孢类、喹诺酮类抗生素的耐药率高,耐药性严重。了解本院大肠埃希菌的多重耐药基因型分布情况对临床使用抗菌药物有指导意义,并降低医院感染发生率。
OBJECTIVE: To investigate the genotype distribution and drug resistance of Escherichia coli producing extended-spectrum β-lactamases (ESBLs) in our hospital, and to provide a reference for the rational use of antibacterials in clinic. Methods: Sixty-eight isolates of ESBLs-producing Escherichia coli isolated from clinical bacterial culture samples in our hospital in 2014 were collected. The genotypes of resistance were determined by polymerase chain reaction (PCR) and sequencing analysis. The drug resistance of Escherichia coli to antibiotics was determined by the minimum inhibitory concentration (MIC) method and compared with 75 ESBL (-) strains of Escherichia coli in the same period. Results: The CTX-M, TEM-1 and CTX-M genotypes were found in 68 ESBLs-positive Escherichia coli isolates, and the same strains were found to carry two CTX-M subtypes Type, not detected SHV type. Escherichia coli ESBLs producing aztreonam, levofloxacin, cotrimoxazole, ciprofloxacin, cefazolin, ceftriaxone resistance rate reached more than 70%. Resistant rate was higher than ESBL (-) of Escherichia coli. Conclusion: The ESBLs-producing Escherichia coli ESBLs genes in our hospital are mainly CTX-M type. CTX-M subtypes are mainly CTX-M-14 and CTX-M-15 type, has a difference. ESBLs-producing Escherichia coli on cephalosporins, quinolone antibiotics high resistance rate, drug resistance. Understanding the distribution of multidrug-resistant genotypes of Escherichia coli in our hospital is instructive for the clinical use of antimicrobial agents and reduces the incidence of nosocomial infections.