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目的:明确青海地区产ESBLs大肠埃希菌,肺炎克雷伯菌主要基因型的分布特点,为临床合理用药提供依据。方法:收集青海5家医院产ESBLs大肠埃希菌和肺炎克雷伯菌共233株(大肠埃希菌189株,肺炎克雷伯菌44株)。采用美国临床实验室标准化委员会规定的ESBL表型筛选和确证试验确定ESBL的发生率、PCR扩增对产ESBL菌初步分型,扩增阳性产物测序和分析,进一步确定基因型。结果:共筛选出208株产ESBLs菌株,检出携带β-内酰胺酶基因菌株128株,基因型别10种,占总样本的61.54%,其中单基因型别92株(CTX-M型68株,TEM-1型24株),占总样本数的44.23%;双基因型别34株,(CTX-M合并TEM-1型32株,两种不同亚型的CTX-M共存2株),占总样本数的16.35%;三基因型别2株,为两种不同亚型的CTX-M合并TEM-1型,占总样本数0.96%。结论:青海地区产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌主要基因型为CTX-M型和TEM-1型。
OBJECTIVE: To determine the distribution characteristics of major genotypes of Escherichia coli and Klebsiella pneumoniae producing ESBLs in Qinghai Province, and to provide basis for clinical rational drug use. Methods: 233 strains of Escherichia coli and Klebsiella pneumoniae were collected from 5 hospitals in Qinghai (189 strains of Escherichia coli and 44 strains of Klebsiella pneumoniae). The incidence of ESBL was determined by ESBL phenotyping and confirmatory test as stipulated by the American Clinical Laboratory Standardization Committee. The genotypes of ESBLs were identified by PCR amplification, sequencing and analysis of positive products of ESBL-producing strains. Results: A total of 208 strains of ESBLs producing strains were screened. Among them, 128 strains carrying β-lactamase gene were detected, of which 10 were genotypes, accounting for 61.54% of the total samples. Among them, 92 strains with single genotype (CTX-M 68 24 strains of TEM-1 type) accounted for 44.23% of the total number of samples, 34 were double genotypes (CTX-M combined with 32 strains of TEM-1 and 2 strains of CTX-M co-existed with two different subtypes) , Accounting for 16.35% of the total number of samples; two genotypes of two genotypes were CTX-M and TEM-1, which accounted for 0.96% of the total samples. Conclusion: The main genotypes of Escherichia coli and Klebsiella pneumoniae producing ESBLs in Qinghai are CTX-M and TEM-1.