摘要
目的对2003-2007年乌鲁木齐地区儿童肺炎患者筛检出的大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌3种革兰阴性耐药菌进行产超广谱β-内酰胺酶(ESBLs)耐药表型和基因分型的研究,以了解ESBLs在儿童革兰阴性耐药菌中的分布及差异性。方法采用VITEK32鉴定分离菌株,根据美国临床实验室标准化研究所(CLSI)的标准,采用K-B法确证ESBLs;最后用基因芯片技术对ESBLs耐药菌进行基因分型。结果耐药表型显示,5年中产酸克雷伯菌ESBLs产生率由84.3%下降至35.3%,肺炎克雷伯菌稳定在50.0%～60.0%,而大肠埃希菌却由34.4%上升为72.1%;基因分型显示,大肠埃希菌多集中在ctx-m-9型和tem+ctx-m-9型,肺炎克雷伯菌大多同时带有tem型和shv型,产酸克雷伯菌则多集中在tem+ctx-m-3型。结论乌鲁木齐地区儿童患者ESBLs产生率较高;3种革兰阴性菌耐药表型和基因型各不相同,应进一步加强对产ESBLs菌株的地方性流行病学监测。
OBJECTIVE To study antibiotic-resistant phenotypes and genotypes of ESBLs-producing Escherichia coli, Klebsiella pneumoniae and Klebsiella oxytoca isolated from children with pneumonia in Urumqi, to know the distribution and difference of these three Gram-negative bacilli from 2003 to 2007. METHODS Bacterial strains were identified by VITEK32, ESBLs were detected by confirmatory test recommended by CLSI. Microarray technique was used to determine the genotypes of ESBLs. RESULTS Antibiotic-resistant phenotypes showed ESBLs-producing K. oxytoca decreasing from 84. 3% to 35.3%, K. pneumoniae stabling in 50-60%, E. coli increasing from 34.4 % to 72.1 N during the five years; genotypes indicated there were most of ctx-m-9 and tern-t- ctx-m-9 in E. coli, tern and shy in K. pneumoniae, and the most of tem-t-ctx-m-3 in K. oxytoca. CONCLUSIONS There is high percentage of ESBLs production from children in Urumqi; resistant phenotypes and genotypes of ESBLs are different in three Gram-negative bacilli; and must further enhance the regional epidemiology surveillance about ESBLs.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第7期913-916,共4页
Chinese Journal of Nosocomiology
基金
乌鲁木齐市科技局科研项目(Y053201)
