摘要
目的探讨产ESBLs宋内志贺菌的耐药机制,为腹泻疾病的临床治疗提供依据。方法收集2004~2007年解放军302医院门诊腹泻患者分离的多重耐药AmpR、SxtR、CtxR的宋内志贺菌43株,用PCR方法扩增耐药基因,并将菌株进行质粒结合试验。结果携带CTX-M基因27株,其中CTX-M1群16株,CTX-M9群11株,占所有阳性分离株的62.79%;携带TEM基因18株,占41.86%;未检出SHV、OXA和PER基因。同时携带CTX和TEM基因占23.26%。携带2类整合子的宋内志贺菌占95.35%（41/43）。质粒结合试验成功率为92.7%。结论北京地区产ESBLs宋内志贺菌以携带CTX-M基因为主,其次为TEM型。流行亚型为CTX-M-15like、CTX-M-14和TEM-1。2类整合子在产ESBLs宋内志贺菌中多见。耐药基因大多通过质粒水平转移的方式进行传播。产CTX-M-27和CTX-M-64的宋内志贺菌在世界和国内分别属首次报告检出。
Objective To study the resistance mechanism of ESBLs-producing Shigella sonnei for clinical rational use of antimicrobial drugs.Methods A total of 43 strains of multidrug resistant Sh.sonnei（mainly AmpR,SxtR and CtxR） were collected,which were isolated from diarrhea patients at our hospital between 2004 and 2007.Plasmid conjugation experiments were conducted,and the resistance genes were amplified by PCR.Results The test results indicated that 27 of these strains carried CTX-M,16 of which carried CTX-M1 group and 11 carried CTX-M9 group,making up 62.79% of the positive isolated strains.Besides,18 of the tested strains carried TEM genes,accounting for 41.86%,but no SHV,OXA or PER genes were identified.Co-carried CTX and TEM that accounted for 23.26 %.95.35% of the Sh.sonnei carried Class 2 integrons.The success rate of plasmid conjugation experiments was 92.7%.Conclusions ESBLs-producing Sh.sonnei in Beijing carrys mostly CTX-M genes,followed by TEM.The prevalent subtypes are CTX-M-15like,CTX-M-14 and TEM-1.Drug-resistant genes are mainly transmitted through plasmid horizontal transfer.Sh.sonnei carrying CTX-M-27 and CTX-M-64 was identified and reported for the first time in China and in the world.
出处
《军事医学》
CAS
CSCD
北大核心
2011年第2期122-127,共6页
Military Medical Sciences
关键词
宋内志贺菌
多重耐药
腹泻
质粒
聚合酶链反应
抗菌药
ESBLS
CTX-M
Shigella sonnei
multidrug resistance
diarrhea
plasmids
polymerase chain reaction
anti-bacterial agents
extended spectrum β-lactamases
CTX-M
