中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2012年
2期
71-75
,共5页
王小妮%魏殿军%张坚磊%李婉琛
王小妮%魏殿軍%張堅磊%李婉琛
왕소니%위전군%장견뢰%리완침
志贺菌属%β内酰胺酶类%基因型%聚合酶链反应%重复序列,核酸%质粒
誌賀菌屬%β內酰胺酶類%基因型%聚閤酶鏈反應%重複序列,覈痠%質粒
지하균속%β내선알매류%기인형%취합매련반응%중복서렬,핵산%질립
Shigella%beta-Lactamases%Genotype%Polymerase chain reaction%Repetitive sequences,nucleic acid%Plasmids
目的 了解天津地区志贺菌属产超广谱β内酰胺酶(ESBL)的流行基因型、耐药特征和流行病学特征,探讨产ESBL志贺菌属特性与耐药质粒的关系.方法 136株志贺菌来源于2009年5月至2010年9月在天津市儿童医院、天津医科大学第二医院及天津市第一中心医院门诊就诊的以脓血便为主的腹泻患者粪便标本,纸片扩散法筛选可疑产ESBL志贺菌属；对产ESBL志贺菌进行接合试验,供体菌和接合子进行耐药性测定,以确定耐药性质粒传递；采用TEM、SHV、CTX-M-1组、CTX-M-2组、CTX-M'9组β内酰胺酶通用引物对产ESBL菌株的基因型进行PCR检测.使用肠杆菌科基因间的重复序列PCR(ERIC-PCR)分析产ESBL菌株的分子同源性.采用x2检验.结果 136株志贺菌属中,产ESBL志贺菌20株,检出率为14.7％,未检测出产AmpC酶菌株.其中16株志贺菌基因型为CTX-M-14型,4株为CTX-M-15型；产CTX-M型ESBL菌株对多种抗菌药物耐药,但对亚胺培南的敏感率为100％.18株产ESBL志贺菌接合试验获得成功,其接合子对β内酰胺类抗菌药物耐药.结论 天津地区志贺菌属产ESBL基因型以CTX-M型为主,产ESBL是志贺菌属对β内酰胺类耐药的主要原因,产ESBL菌株的传播机制以质粒介导为主.
目的 瞭解天津地區誌賀菌屬產超廣譜β內酰胺酶(ESBL)的流行基因型、耐藥特徵和流行病學特徵,探討產ESBL誌賀菌屬特性與耐藥質粒的關繫.方法 136株誌賀菌來源于2009年5月至2010年9月在天津市兒童醫院、天津醫科大學第二醫院及天津市第一中心醫院門診就診的以膿血便為主的腹瀉患者糞便標本,紙片擴散法篩選可疑產ESBL誌賀菌屬；對產ESBL誌賀菌進行接閤試驗,供體菌和接閤子進行耐藥性測定,以確定耐藥性質粒傳遞；採用TEM、SHV、CTX-M-1組、CTX-M-2組、CTX-M'9組β內酰胺酶通用引物對產ESBL菌株的基因型進行PCR檢測.使用腸桿菌科基因間的重複序列PCR(ERIC-PCR)分析產ESBL菌株的分子同源性.採用x2檢驗.結果 136株誌賀菌屬中,產ESBL誌賀菌20株,檢齣率為14.7％,未檢測齣產AmpC酶菌株.其中16株誌賀菌基因型為CTX-M-14型,4株為CTX-M-15型；產CTX-M型ESBL菌株對多種抗菌藥物耐藥,但對亞胺培南的敏感率為100％.18株產ESBL誌賀菌接閤試驗穫得成功,其接閤子對β內酰胺類抗菌藥物耐藥.結論 天津地區誌賀菌屬產ESBL基因型以CTX-M型為主,產ESBL是誌賀菌屬對β內酰胺類耐藥的主要原因,產ESBL菌株的傳播機製以質粒介導為主.
목적 료해천진지구지하균속산초엄보β내선알매(ESBL)적류행기인형、내약특정화류행병학특정,탐토산ESBL지하균속특성여내약질립적관계.방법 136주지하균래원우2009년5월지2010년9월재천진시인동의원、천진의과대학제이의원급천진시제일중심의원문진취진적이농혈편위주적복사환자분편표본,지편확산법사선가의산ESBL지하균속；대산ESBL지하균진행접합시험,공체균화접합자진행내약성측정,이학정내약성질립전체；채용TEM、SHV、CTX-M-1조、CTX-M-2조、CTX-M'9조β내선알매통용인물대산ESBL균주적기인형진행PCR검측.사용장간균과기인간적중복서렬PCR(ERIC-PCR)분석산ESBL균주적분자동원성.채용x2검험.결과 136주지하균속중,산ESBL지하균20주,검출솔위14.7％,미검측출산AmpC매균주.기중16주지하균기인형위CTX-M-14형,4주위CTX-M-15형；산CTX-M형ESBL균주대다충항균약물내약,단대아알배남적민감솔위100％.18주산ESBL지하균접합시험획득성공,기접합자대β내선알류항균약물내약.결론 천진지구지하균속산ESBL기인형이CTX-M형위주,산ESBL시지하균속대β내선알류내약적주요원인,산ESBL균주적전파궤제이질립개도위주.
Objective To study genotypes,antibiotic resistance and epidemiology of extendedspectrum β-lactamases (ESBL)-producing Shigella isolated in Tianjin,and to discuss the relationship between ESBL-producing Shigella and drug-resistance plasmid.Methods A total of 136 Shigella spp.were isolated from stool specimens of patients with diarrhea who presented mainly with bloody purulent stool from Tianjin Children's Hospital,Tianjin Medical University No.2 Hospital and Tianjin No.1 Central Hospital between May 2009 and September 2010.Suspicious ESBL-producing isolates were screened by K-B disc diffusion method. The conjugation experiment was performed in the confirmed ESBL-producing strains and antibiotic resistance was compared between clinical strains and transconjugants to confirm the plasmid-mediated resistance. The genotypes of these isolates were detected by polymerase chain reaction (PCR) using universal primers for TEM,SHV,CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,respectively.Intergenic consensus PCR (ERIC-PCR) was employed to understand the molecular homology of the ESBL-producing isolates. The data were analyzed by x2 test.Results ESBL were identified in 14.7％ (20/136) of Shigella isolates,but no AmpC enzyme were detected.Among all the Shigella isolates,16 strains were genotype CTX-M-14,4 were genotype CTX-M-15.The strains with CTX-M ESBL were resistant to multiple antibiotics,while 100％ sensitive to imipenem.The transconjugant test of 18 ESBL-producing isolates were positive,and these conjugations were only resistant to β-lactamases. Conclusions CTX-M type is the common genotype of ESBL-producing Shigella isolates in Tianjin. ESBL-producing is the main cause of multiple resistance to β-lactams.The transmission of CTX-M producing strains is mainly mediated by plasmids.
