中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2009年
10期
1114-1119
,共6页
卓超%苏丹虹%李红玉%王露霞%廖康%王媚%植志全%郭仲辉%魏衍超%耿穗娜%金光耀%钟南山
卓超%囌丹虹%李紅玉%王露霞%廖康%王媚%植誌全%郭仲輝%魏衍超%耿穗娜%金光耀%鐘南山
탁초%소단홍%리홍옥%왕로하%료강%왕미%식지전%곽중휘%위연초%경수나%금광요%종남산
大肠杆菌%克雷伯菌%肺炎%β内酰胺酶类%大肠杆菌蛋白质类%表型%微生物敏感性试验%聚合酶链反应
大腸桿菌%剋雷伯菌%肺炎%β內酰胺酶類%大腸桿菌蛋白質類%錶型%微生物敏感性試驗%聚閤酶鏈反應
대장간균%극뢰백균%폐염%β내선알매류%대장간균단백질류%표형%미생물민감성시험%취합매련반응
Escherichia coli%Klebsiella pneumoniae%beta-Lactamases%Escherichia coli proteins%Phenotype%Micrebiol sensitivity tests%Polymerase chain reaction
目的 研究广州地区大肠埃希菌和肺炎克雷伯菌CTX-M型超广谱β内酰胺酶(ESBLs)的分子表型、流行病学和耐药基因环境特征.方法 收集2007-2008年广州地区9家医院临床分离产ESBLs的181株大肠埃希菌和180株肺炎克雷伯菌,通过PCR检测ESBLs分子表型;通过接合试验、质粒图谱、PCR分析CTX-M-15型ESBLs的基因环境,肠杆菌科基因间重复序列引物PCR(ERIC-PCR)分析产CTX-M-15型ESBLs菌株的分子同源性.结果 67.3%(243/361)的ESBLs产生株为CTX-M表型,其中CTX-M-1群和CTX-M-9群各占46.9%(114/243)和53.1%(129/243),未发现其他CTX-M亚群.CTX-M-14和CTXM-15是最常见的ESBLs基因型,其中CTX-M-14在大肠埃希菌和肺炎克雷伯菌的检出率分别35.4%(64/181)和28.3%(51/180),CTX-M-15在这两种菌的检出率分别为21.5%(39/181)和26.1%(47/180),此外还检出对头孢他啶有水解活性的CTX-M-55、CTX-M-19和CTX-M-27.采用ERIC-PER分析CTX-M-15产生株的同源性,39株大肠埃希菌被分为28个基因型,47株肺炎克雷伯菌被分为30个基因型.67.6%(25/37)和32.4%(12/37)bla_(CTX-M-15)分别位于65 000 bp和90 000 bp的可接合质粒上,65 000 bp质粒除bla_(CTX-M-15)阳性外,未检到bla_(TEM-1)、qnrB、bla_(DHA-1)、bla_(OXA-1),aac(6′)-I6-cr等耐药基因.1株接合菌90 000 bp质粒还存在bla_(OXA-1)和bla_(TEM-1)耐药基因,其余7个90 000 bp质粒所携耐药基因同65 000 bp质粒.所有bla_(CTX-M-15)都位于ISEcp1-like插入序列下游,ISEep1-like末端与blaCTX-M-15间距均为48 bp.结论 广州地区ESBLs主要分子表型为CTX-M型主要流行为CTX-M-14型.以CTX-M-15为代表能水解头孢他啶的CTX-M型ESBLs在本地区检出增多值得关注.
目的 研究廣州地區大腸埃希菌和肺炎剋雷伯菌CTX-M型超廣譜β內酰胺酶(ESBLs)的分子錶型、流行病學和耐藥基因環境特徵.方法 收集2007-2008年廣州地區9傢醫院臨床分離產ESBLs的181株大腸埃希菌和180株肺炎剋雷伯菌,通過PCR檢測ESBLs分子錶型;通過接閤試驗、質粒圖譜、PCR分析CTX-M-15型ESBLs的基因環境,腸桿菌科基因間重複序列引物PCR(ERIC-PCR)分析產CTX-M-15型ESBLs菌株的分子同源性.結果 67.3%(243/361)的ESBLs產生株為CTX-M錶型,其中CTX-M-1群和CTX-M-9群各佔46.9%(114/243)和53.1%(129/243),未髮現其他CTX-M亞群.CTX-M-14和CTXM-15是最常見的ESBLs基因型,其中CTX-M-14在大腸埃希菌和肺炎剋雷伯菌的檢齣率分彆35.4%(64/181)和28.3%(51/180),CTX-M-15在這兩種菌的檢齣率分彆為21.5%(39/181)和26.1%(47/180),此外還檢齣對頭孢他啶有水解活性的CTX-M-55、CTX-M-19和CTX-M-27.採用ERIC-PER分析CTX-M-15產生株的同源性,39株大腸埃希菌被分為28箇基因型,47株肺炎剋雷伯菌被分為30箇基因型.67.6%(25/37)和32.4%(12/37)bla_(CTX-M-15)分彆位于65 000 bp和90 000 bp的可接閤質粒上,65 000 bp質粒除bla_(CTX-M-15)暘性外,未檢到bla_(TEM-1)、qnrB、bla_(DHA-1)、bla_(OXA-1),aac(6′)-I6-cr等耐藥基因.1株接閤菌90 000 bp質粒還存在bla_(OXA-1)和bla_(TEM-1)耐藥基因,其餘7箇90 000 bp質粒所攜耐藥基因同65 000 bp質粒.所有bla_(CTX-M-15)都位于ISEcp1-like插入序列下遊,ISEep1-like末耑與blaCTX-M-15間距均為48 bp.結論 廣州地區ESBLs主要分子錶型為CTX-M型主要流行為CTX-M-14型.以CTX-M-15為代錶能水解頭孢他啶的CTX-M型ESBLs在本地區檢齣增多值得關註.
목적 연구엄주지구대장애희균화폐염극뢰백균CTX-M형초엄보β내선알매(ESBLs)적분자표형、류행병학화내약기인배경특정.방법 수집2007-2008년엄주지구9가의원림상분리산ESBLs적181주대장애희균화180주폐염극뢰백균,통과PCR검측ESBLs분자표형;통과접합시험、질립도보、PCR분석CTX-M-15형ESBLs적기인배경,장간균과기인간중복서렬인물PCR(ERIC-PCR)분석산CTX-M-15형ESBLs균주적분자동원성.결과 67.3%(243/361)적ESBLs산생주위CTX-M표형,기중CTX-M-1군화CTX-M-9군각점46.9%(114/243)화53.1%(129/243),미발현기타CTX-M아군.CTX-M-14화CTXM-15시최상견적ESBLs기인형,기중CTX-M-14재대장애희균화폐염극뢰백균적검출솔분별35.4%(64/181)화28.3%(51/180),CTX-M-15재저량충균적검출솔분별위21.5%(39/181)화26.1%(47/180),차외환검출대두포타정유수해활성적CTX-M-55、CTX-M-19화CTX-M-27.채용ERIC-PER분석CTX-M-15산생주적동원성,39주대장애희균피분위28개기인형,47주폐염극뢰백균피분위30개기인형.67.6%(25/37)화32.4%(12/37)bla_(CTX-M-15)분별위우65 000 bp화90 000 bp적가접합질립상,65 000 bp질립제bla_(CTX-M-15)양성외,미검도bla_(TEM-1)、qnrB、bla_(DHA-1)、bla_(OXA-1),aac(6′)-I6-cr등내약기인.1주접합균90 000 bp질립환존재bla_(OXA-1)화bla_(TEM-1)내약기인,기여7개90 000 bp질립소휴내약기인동65 000 bp질립.소유bla_(CTX-M-15)도위우ISEcp1-like삽입서렬하유,ISEep1-like말단여blaCTX-M-15간거균위48 bp.결론 엄주지구ESBLs주요분자표형위CTX-M형주요류행위CTX-M-14형.이CTX-M-15위대표능수해두포타정적CTX-M형ESBLs재본지구검출증다치득관주.
Objective To study phylogenies, epidemiology and genetic environment of CTX-M type of ESBLs produced by Escherichia coli and Klebsiella pneumoniae isolated from nine hospitals in Guangzhou. Methods The phylogenies of CTX-M type of ESBLs were analyzed by PCR Genetic environment of CTX-M-15 encoding gene (bla_(CTX-M-15)) were investigated by conjugation test and plasmid analysis. The clonal relationship of strains producing CTX-M-15 was determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Results A total of 361 ESBLs-producing isolates of Escherichia coli and Klebsiella pneumoniae were collected. 67.3% of ESBLs strains were detected to produce CTX-M-type ESBLs, and the commonest genotypes in Escherichia coli and Klebsiella pneumoniae were CTX-M-14 (35.4% and 28.3%), CTX-M-15(21.5% and 26.1%) EBIC-PCR products of all CTX-M-15-producing strains show 39 strains of Escherichia coli were classified into 27 genotypes while 43 strains of Klebsiella pneumoniae were divided into 30 genotypes. Furthermore, the genotypes of CTX-M-55, CTX-M-19, CTX-M-27, with ceftazidime-hydrelyzing activity, were detected in this study. The great majority of bla_(CTX-M-15) genes were found to locate on a 65 000 bp-conjugative plasmid, and there was no blaTEM-1, bla_(OXA-1), blaDSA-1 or aac (6')-Ib-cr gene coexisted on the plasmid, ISEcp1-like insertion sequences, relative to mobilization of bla_(CTX-M-15) gene, were detected in all bla_(CTX-M-15) positive strains, and the distances between the end of ISEcp1-like insertion sequences and the start cedon of bla_(CTX-M-15) were equal, with 48 base pairs. Conclusion CTX-M-14 is still the most common genotype of ESBLs in Guangzhou, but high prevalence of CTX-M-15 ESBLs hydrolyzing ceftazidime already appears in south China.
