中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
CHINESE JOURNAL OF INFECTION CONTROL
2014年
9期
524-529
,共6页
黄小荣%刘配辰%蔡瑞昭%陈晓燕%黄浩泉%周俊宜
黃小榮%劉配辰%蔡瑞昭%陳曉燕%黃浩泉%週俊宜
황소영%류배신%채서소%진효연%황호천%주준의
整合子%大肠埃希菌%耐药机制%多重耐药%抗药性,微生物%抗菌药物%合理用药
整閤子%大腸埃希菌%耐藥機製%多重耐藥%抗藥性,微生物%抗菌藥物%閤理用藥
정합자%대장애희균%내약궤제%다중내약%항약성,미생물%항균약물%합리용약
integron%Escherichia coli%drug-resistance mechanism%multidrug-resistance%drug resistance,mi-crobial%antimicrobial agent%rational drug use
目的:了解临床分离大肠埃希菌对常用抗菌药物的耐药状况;研究整合子在大肠埃希菌中的分布情况,探讨其与大肠埃希菌耐药性之间的相关性。方法收集广东省3所医院20102012年分离的大肠埃希菌,采用 K-B 纸片扩散法进行药敏试验;聚合酶链反应(PCR)法扩增3类整合子整合酶基因和整合子可变区,测序分析整合子所携带的耐药基因盒类型。结果共收集156株大肠埃希菌,其对青霉素类、头孢菌素类、氟喹诺酮类、氨基糖苷类和磺胺类等的大多数抗菌药物的耐药率>50%;耐药率<10%的抗菌药物有头孢哌酮/舒巴坦(0)、亚胺培南(3.85%)、头孢替坦(4.35%)、厄他培南(7.69%)和哌拉西林/他唑巴坦(8.97%);I 类整合子的检出率为57.69%(90/156),多重耐药菌与非多重耐药菌的整合子检出率分别为66.00%(66/100)和64.71%(22/34),两组比较,差异无统计学意义(P >0.05),但分别与敏感菌组(9.09%,2/22)相比,差异均有统计学意义(P <0.01)。所检出的整合子可变区分为9种类型,大部分都含有 aadA 和 dfrA 耐药基因盒。结论大肠埃希菌整体耐药情况严重;I 类整合子在临床分离大肠埃希菌中分布广泛,并与大肠埃希菌的耐药性关系密切,主要介导对氨基糖苷类、磺胺类、β-内酰胺类等多种抗菌药物的耐药性。
目的:瞭解臨床分離大腸埃希菌對常用抗菌藥物的耐藥狀況;研究整閤子在大腸埃希菌中的分佈情況,探討其與大腸埃希菌耐藥性之間的相關性。方法收集廣東省3所醫院20102012年分離的大腸埃希菌,採用 K-B 紙片擴散法進行藥敏試驗;聚閤酶鏈反應(PCR)法擴增3類整閤子整閤酶基因和整閤子可變區,測序分析整閤子所攜帶的耐藥基因盒類型。結果共收集156株大腸埃希菌,其對青黴素類、頭孢菌素類、氟喹諾酮類、氨基糖苷類和磺胺類等的大多數抗菌藥物的耐藥率>50%;耐藥率<10%的抗菌藥物有頭孢哌酮/舒巴坦(0)、亞胺培南(3.85%)、頭孢替坦(4.35%)、阨他培南(7.69%)和哌拉西林/他唑巴坦(8.97%);I 類整閤子的檢齣率為57.69%(90/156),多重耐藥菌與非多重耐藥菌的整閤子檢齣率分彆為66.00%(66/100)和64.71%(22/34),兩組比較,差異無統計學意義(P >0.05),但分彆與敏感菌組(9.09%,2/22)相比,差異均有統計學意義(P <0.01)。所檢齣的整閤子可變區分為9種類型,大部分都含有 aadA 和 dfrA 耐藥基因盒。結論大腸埃希菌整體耐藥情況嚴重;I 類整閤子在臨床分離大腸埃希菌中分佈廣汎,併與大腸埃希菌的耐藥性關繫密切,主要介導對氨基糖苷類、磺胺類、β-內酰胺類等多種抗菌藥物的耐藥性。
목적:료해림상분리대장애희균대상용항균약물적내약상황;연구정합자재대장애희균중적분포정황,탐토기여대장애희균내약성지간적상관성。방법수집광동성3소의원20102012년분리적대장애희균,채용 K-B 지편확산법진행약민시험;취합매련반응(PCR)법확증3류정합자정합매기인화정합자가변구,측서분석정합자소휴대적내약기인합류형。결과공수집156주대장애희균,기대청매소류、두포균소류、불규낙동류、안기당감류화광알류등적대다수항균약물적내약솔>50%;내약솔<10%적항균약물유두포고동/서파탄(0)、아알배남(3.85%)、두포체탄(4.35%)、액타배남(7.69%)화고랍서림/타서파탄(8.97%);I 류정합자적검출솔위57.69%(90/156),다중내약균여비다중내약균적정합자검출솔분별위66.00%(66/100)화64.71%(22/34),량조비교,차이무통계학의의(P >0.05),단분별여민감균조(9.09%,2/22)상비,차이균유통계학의의(P <0.01)。소검출적정합자가변구분위9충류형,대부분도함유 aadA 화 dfrA 내약기인합。결론대장애희균정체내약정황엄중;I 류정합자재림상분리대장애희균중분포엄범,병여대장애희균적내약성관계밀절,주요개도대안기당감류、광알류、β-내선알류등다충항균약물적내약성。
Objective To study antimicrobial resistance of clinically isolated Escherichia coli (E.coli),the preva-lence of integrons in E.coli,and relation of integron with antimicrobial resistance of E.coli.Methods E.coli isola-ted from three hospitals of Guangdong Province from 2010 to 2012 were collected,and antimicrobial susceptibility testing was performed by Kirby-Bauer method;integrons were detected by polymerase chain reaction (PCR),and gene cassette was analyzed by sequencing.Results A total of 156 E.coli isolates were collected,antimicrobial sus-ceptibility testing showed that resistance rate of E.coli to most penicillins,cephalosporins,fluoroquinolones,amin-oglycosides and sulfonamides were over 50%;the resistance rate to antimicrobials < 10% included cefoperazone/sulbactam(0),imipenem(3.85%),cefotetan(4.35%),ertapenem(7.69%)and piperacillin /tazobactam (8.97%);The positive rate of class I integron was 57.69%(90/156);the positive rate of class I integron in multidrug-resist-ant and non-multidrug-resistant E.coli was 66.00% (66/100)and 64.71 % (22/34)respectively,the difference was not statistically different (P >0.05),but compared with sensitive E.coli (9.09%,2/22),the difference was statisti-cally different (P<0.01 ).There were nine types of integron-drug resistant gene cassettes in the variable regions, most of which contained aadA and dfrA.Conclusion Antimicrobial resistance of E.coli is serious;high incidence of class I integrons are widely found in E.coli,and is closely related with drug resistance of E.coli,class I integrons mainly mediated aminoglycosides,sulfonamides and beta-lactams resistance.