产ESBLs大肠埃希菌基因型分析

张阮章; 王沙燕; 陈升汶; 卢月梅; 何林

doi:10.11847/zgggws2006-22-02-30

产ESBLs大肠埃希菌基因型分析

Analysis on molecular epidemiological investigation of nosocomial ESBLs-producing Escherichia coli

摘要

摘要:
目的了解医院感染的产超广谱β-内酰胺酶(ESBLs)大肠埃希菌医院感染的临床分布及其基因型特征。
方法用表型确证试验确定临床标本中产ESBLs大肠埃希菌151株, 应用PCR方法分别扩增产酶菌株的TEM、SHV和CTX-M 3种β-内酰胺酶基因, 并对PCR扩增结果及ESBLs株临床分布进行分析。
结果 PCR扩增结果显示, CTX-M、TEM和SHV基因的阳性率分别为92.10%, 49.7%和1.30%;48.3%的菌株同时携带多个基因。产ESBLs大肠埃希菌广泛分布于24个临床科室, 其中普外科占23.2%, 重症监护病房占10.6%。标本分布较为集中, 29.8%来自尿液, 24.5%来自呼吸道标本, 23.9%来自穿刺液。
结论医院感染中, 产ESBLs大肠埃希菌的主要基因型是CTX-M, 尿液、呼吸道标本、穿刺液是其主要来源, 产ESBLs菌分布广泛, 需引起重视。

Abstract:
Objective To understand the distribution and genotypic character of Escherichia coli producing extended spectru beta-lactamases(ESBLs).
Methods 151 ESBL-sproducing Escherichia coli were determined by phennotyic confirmatory test accor ding to NCCLS standards.Beta-lactamase genes of TEM, SHV and CTX-Min ESBLs-producing isolates were amplified by PCR, respectively.
Results Of all isolates, 92.1%, 49.7%and 1.3% were respectively found carrying CTX-M, TEM and SHV gene.In addition, 48.3% of all strains carrying more than one bet-alactamase gene.ESBL-producing isolates were widely distrbuted over 24 clinical departments.23.9% of the isolates were provided from common surgery depar tment and 10.6% from intensive care unit.Urine and sputum and paracentesis fluid were three kinds of commom samples, accunting for 29.8%, 24.5% and 23.9%, respectively.
Conclusion The predominan genotype of nosocomial ESBLsproducing Escherichia coli was CTX-M.ESBL-producing isolates mostly came from urine, sputum or paracentesis liquid, they were widely prevalent in that hospital.

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