产ESBLs肺炎克雷伯菌耐药基因分型及药敏试验结果分析

目的 了解本地区产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌的耐药性及基因型分布。方法 用表型确证试验确定临床标本中产ESBLs肺炎克雷伯菌64株，用琼脂稀释法测定其最低抑菌浓度(MIC)，分别用TEM、SHV和CTX-M通用引物进行聚合酶链反应(PCR)，并对结果进行分析。结果 产ESBLs肺炎克雷伯菌对亚胺培南的敏感率最高(100％)；其次为头孢吡肟(84．4％)，哌拉西林／他唑巴坦和环丙沙星的敏感率则分别为71．9％和70．3％。PCR扩增结果显示SHV、CTX-M和TEM基因的阳性率分别为81．3％、65．6％和18．8％；53．1％的菌株同时携带多个基因。结论 该院医院感染产ESBLs肺炎克雷伯菌对亚胺培南的敏感率最高；最常见的基因型是SHV，其次为CTX-M。

An Analysis of Genotype and Antibiotic Resistance of ESBLs- producing Klebsiella Pneumoniae

Objective To understand the profile of genotype and antibiotic resistance of strains producing extended spectrum beta-lactamases (ESBLs). Methods 46 ESBLs-producing Klebsiella pneumoniae strains were determined by phennotyic confirmatory test. MICs of antibiotic to the isolates were determined by the agar dilution method. The presence of the TEM, SHV and CTX-M genes were determined by specific PCR assays. Results MIC test show these strains were 100% susceptible to imipenem , 84.4% to cefepime,71.9% to piperacillin/tazobactam, 70.3% to ciprofloxacin.Of all ESBLs, 81.3% were SHV, 65.6% were CTX-M and 18.8% were TEM . 53.1% of strains carried more than one type of ESBLs gene. Conclusions ESBLs-producing Klebsiella pneumoniae showed most susceptibility to imipenem. The most commom ESBLs in Klebsiella pneumoniae was SHV in our hospital, and the next was CTX-M.