论文部分内容阅读
目的研究儿科患者感染大肠埃希菌的耐药性及其耐药基因与可移动遗传元件的分布情况,为儿科患者抗感染治疗及致病菌耐药性的控制提供指导。方法收集本院2014年1月至2014年12月就诊的儿科患者临床标本,经分离、鉴定共获得大肠埃希菌201株。采用K-B法进行药敏试验,根据2015年CLSI标准判定结果。提取大肠埃希菌基因组DNA并设计耐药基因、可移动遗传元件扩增引物,通过PCR扩增检测其分布情况。结果药敏试验显示大肠埃希菌对阿米卡星、庆大霉素、氨苄西林、头孢唑林、头孢呋辛、头孢吡肟、头孢噻肟、头孢他啶、环丙沙星、妥布霉素、左氧氟沙星、亚胺培南、亚胺培南/西司他丁的耐药率分别为15.92%、33.83%、100.00%、64.68%、47.76%、4.98%、36.82%、18.91%、48.26%、38.81%、50.75%、12.94%和0.00%。PCR扩增ISCR1、IMP、tnpU、TEM、CTX-M-1、NDM-1、ant(3’’)-Ⅰ、traA、qnr、aac(3)-Ⅱ、IS26、intⅠ1和SHV基因大小分别为475、587、403、535、891、287、284、272、240、237、387、373和305bp;IMP、CTX-M-1、TEM、SHV、NDM-1、aac(3)-Ⅱ、ant(3’)-Ⅰ、qnr、intⅠ1、IS26、traA、tnpU和ISCR1基因阳性率分别为8.96%、46.77%、55.72%、42.79%、3.98%、48.76%、29.85%、52.74%、54.73%、90.05%、80.60%、19.90%和39.80%。结论儿科患者感染大肠埃希菌除了对亚胺培南/西司他丁敏感外,对其余检测药物均耐药,其耐药性的产生与其耐药基因及遗传元件的分布情况关系密切。
Objective To study the drug resistance of pediatric patients infected with Escherichia coli and the distribution of drug resistance genes and mobile genetic elements in order to provide guidance for anti-infective treatment and the control of pathogenic drug resistance in pediatric patients. Methods A total of 201 pediatric Escherichia coli strains were collected from January 2014 to December 2014 in our hospital and were isolated and identified. K-B method for susceptibility testing, according to the 2015 CLSI criteria to determine the results. The genomic DNA of Escherichia coli was extracted and drug resistance genes were designed. The primers were amplified by mobile genetic element, and their distribution was detected by PCR amplification. Results The susceptibility test showed that Escherichia coli could inhibit amikacin, gentamicin, ampicillin, cefazolin, cefuroxime, cefepime, cefotaxime, ceftazidime, ciprofloxacin, tobramycin , The levofloxacin, imipenem and imipenem / cilastatin were 15.92%, 33.83%, 100.00%, 64.68%, 47.76%, 4.98%, 36.82%, 18.91%, 48.26% 38.81%, 50.75%, 12.94% and 0.00%. The gene sizes of ISCR1, IMP, tnpU, TEM, CTX-M-1, NDM-1, ant (3 ") - Ⅰ, traA, qnr, aac (3) -II, IS26, 285, 891, 287, 284, 272, 240, 237, 387, 377 and 375 bp; IMP, CTX- M- 1, TEM, SHV, NDM- 1, aac (3) The positive rates of (3 ’) - Ⅰ, qnr, intⅠ1, IS26, traA, tnpU and ISCR1 genes were 8.96%, 46.77%, 55.72%, 42.79%, 3.98%, 48.76%, 29.85%, 52.74%, 54.73% 90.05%, 80.60%, 19.90% and 39.80%. Conclusion In addition to being sensitive to imipenem / cilastatin, the infection of Escherichia coli in pediatric patients is resistant to the other drugs tested. The drug resistance is closely related to the distribution of drug resistance genes and genetic elements.