目的 了解引起医院感染的阴沟肠杆菌临床菌株ESBLs的分布及流行情况,为控制ESBLs流行提供依据.方法 连续收集了27株不重复的对头孢他啶或头孢噻肟耐药的阴沟肠杆菌临床菌株,采用系列ESBLs特异性引物进行PCR,并对PCR产物测序;同时采用ERIC2引物进行rep-PCR.结果 对头孢他啶或头孢噻肟耐药的阴沟肠杆菌临床菌株中最为流行的ESBLs是CTX-M-3样（13株阳性,占48%）;在我国首次发现肠杆菌科细菌中有VEB-1样β-内酰胺酶流行;产ESBLs阴沟肠杆菌大多具有克隆相关性,它们在流行过程中又分别获得了不同的ESBLs耐药基因.结论 上海华山医院引起医院感染的阴沟肠杆菌ESBLs产生率高,是阴沟肠杆菌对β-内酰胺类药物耐药的重要原因.
OBJECTIVE To understand the distribution and epidemiology of ESBLs in ceftazidime or cefotaxime-resistant clinical Enterobacter cloacae isolates. METHODS Twenty seven ceftazidime or cefotaxime-resistant nonrepetitive E. cloacae were collected from 27 patients hospitalized at the Huashan Hospital, Shanghai. PCR and sequencing were performed to understand the distribution of ESBLs in E. cloacae; rep-PCR was performed to understand the epidemiology of ESBLs in E. cloacae. RESULTS CTX-M-3 like ESBLs were the most prevalent in our study （48%）; this was the first report of VEB-1-like ESBLs in the member of Enterobacteriaceae in China, and the first report of the ESBLs VEB-1-like and CTX-M-3-like in an isolate simultaneously; the majority of ESBLs producers exhibited the same rep-PCR pattern, but harbored different ESBLs gene. CONCLUSIONS In our study, ESBLs have become prevalent in clinical E. cloacae isolates, and become an important factor of E. cloacae isolates resistant to extended-spectrum beta-lactams.
Chinese Journal of Nosocomiology