住院患者产CTX-M型ESBLs和KPC的大肠埃希菌感染分布与耐药基因分析
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蒋伟

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R181.3+2

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Distribution and antimicrobial resistance genes of CTX-M extended-spectrum β-lactamase- and Klebsiella pneumoniae carbapenemasesproducing Escherichia coli isolated from patients with infection
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    摘要:

    目的了解住院患者产CTXM型超广谱β内酰胺酶(ESBLs)和碳青霉烯酶(KPC)大肠埃希菌感染的临床分布与耐药情况。方法收集某院2011—2012年临床送检标本分离的多重耐药大肠埃希菌,采用微量肉汤稀释法检测抗菌药物最低抑菌浓度(MIC);聚合酶链反应(PCR)扩增ESBLs和KPC基因,确定CTXM和KPC基因型别及MLST分型。结果48株多重耐药大肠埃希菌中单产ESBLs 45株(93.75%),携带blaCTXM基因者44株(91.67%),其中blaCTXM1组基因20株(41.67%)、blaCTXM9组基因32株(66.67%),同时携带两组基因者8株(16.67%)。经基因测序确定的基因亚型有CTXM14(65.91%,29/44)、CTXM55(31.82%,14/44)、CTXM15(11.36%,5/44)、CTXM3(2.27%,1/44)、CTXM24(2.27%,1/44)和CTXM65(2.27%,1/44),其中CTXM14+CTXM55(11.36%,5/44)、CTXM14+CTXM15(4.55%,2/44)和CTXM55+CTXM65(2.27%,1/44)。产ESBLs+KPC菌株中2株(4.17%)经PCR扩增均携带blaKPC和 blaCTXM基因,经测序分析1株为CTXM14+KPC2,1株为CTXM3+KPC2。ST131 (53.66%)是主要的MLST型别,检测到ST648、ST405、ST167、ST1193等ST型。 结论该院大肠埃希菌产ESBLs基因型中CTXM14、CTXM55和CTXM15亚型最常见,存在多种不同亚型;ST131是主要的MLST型别,检测到产KPC2型碳青霉烯酶菌。

    Abstract:

    ObjectiveTo investigate clinical distribution and antimicrobial resistance genes of  CTXM extendedspectrum βlactamases (ESBLs) and Klebsiella pneumoniae carbapenemases (KPCs)producing Escherichia coli (E. coli) isolated from patients with infection. MethodsMultidrugresistant E. coli (MDRE. coli) isolated from clinical specimens in a hospital in 2011-2012 were collected, minimal inhibitory concentrations (MICs) were detected by microbroth dilution method; ESBLs and KPC genes were amplified by polymerase chain reaction (PCR),  CTXM and KPC genotypes,as well as multilocus sequence types (MLST) were identified. ResultsOf 48 MDRE.coli, 45(93.75%) only produced ESBLs, 44(91.67%) carried  blaCTXM gene, 20(41.67%) of which were blaCTXM1 gene and 32(66.67%)were blaCTXM9 gene,8(16.67%)carried both genes. The following subtypes were identified through gene sequencing: CTXM14(65.91%,29/44), CTXM55(31.82%,14/44), CTXM15(11.36%,5/44), CTXM3(2.27%,1/44), CTXM24(2.27%,1/44),and CTXM65(2.27%,1/44). The detection rates of CTXM14+CTXM55, CTXM14+CTXM15, and CTXM55+CTXM65 were 11.36% (5/44), 4.55%(2/44), and 2.27%(1/44)respectively. PCR showed that 2(4.17%) ESBLs+KPCproducing strains carried blaKPC and  blaCTXM genes, sequencing analysis showed that 1 was CTXM14+KPC2,and the other was CTXM3+KPC2. ST 131 (53.66%)was the main type of MLST,  ST648, ST405, ST167, and ST1193 were also detected. ConclusionCTXM14, CTXM55 and CTXM15 are the most common genotypes of ESBLsproducing E. coli isolates, different subtypes exists, ST131 is the predominant MLST, KPC2producing  isolate of E.coli has been detected.

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蒋伟, 王思淼, 金鑫,等.住院患者产CTX-M型ESBLs和KPC的大肠埃希菌感染分布与耐药基因分析[J]. 中国感染控制杂志,2016,15(10):760-763. DOI:10.3969/j. issn.1671-9638.2016.10.010.
JIANG Wei, WANG Simiao, JIN Xin, et al. Distribution and antimicrobial resistance genes of CTX-M extended-spectrum β-lactamase- and Klebsiella pneumoniae carbapenemasesproducing Escherichia coli isolated from patients with infection[J]. Chin J Infect Control, 2016,15(10):760-763. DOI:10.3969/j. issn.1671-9638.2016.10.010.

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  • 收稿日期:2016-01-28
  • 最后修改日期:2016-04-23
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  • 在线发布日期: 2016-10-26
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