论文部分内容阅读
目的了解浙江省社区和医院获得性尿道致病性大肠埃希菌的耐药现状及产超广谱β-内酰胺酶(ESBLs)菌株基因型,为临床合理用药提供科学依据。方法对2014年1月至2014年12月浙江省社区和医院获得性尿道致病性大肠埃希菌耐药情况进行分析,并随机各抽取20株菌株进行CTX-M基因型检测。结果社区和医院获得性大肠埃希菌共收集到93株和992株,产ESBLs菌株的阳性率分别为47.7%和68.5%,差异有统计学意义(P<0.05);社区获得性菌株CTX-M基因检出率为30.0%(6/20),其中又以CTX-M-9为主(4/6)。医院获得性菌株CTX-M基因检出率50.0%(10/20),其中CTX-M-9占7/10。医院获得性菌株对头孢呋辛、头孢唑啉、头孢曲松、环丙沙星、左旋氧氟沙星、甲氧苄氨嘧啶/磺胺甲恶唑、呋喃妥因和阿米卡星的敏感率明显低于社区获得性菌株(P<0.05)。结论浙江省医院获得性尿道致病性大肠埃希菌对部分抗菌药物的耐药率明显高于社区获得性菌株,ESBLs基因以CTX-M-9为主。
Objective To understand the drug-resistant status of acquired pathogenic E.coli in community and hospital in Zhejiang province and genotypes of extended-spectrum β-lactamase (ESBLs) producing strains, and to provide a scientific basis for clinical rational drug use. Methods The pathogenic Escherichia coli resistance of acquired urethral in community and hospital of Zhejiang Province from January 2014 to December 2014 was analyzed. Twenty strains were randomly selected for CTX-M genotype detection. Results The positive rates of community-acquired and hospital-acquired Escherichia coli in 93 and 992 strains were 47.7% and 68.5%, respectively, with statistically significant difference (P <0.05). Community-acquired strains CTX- The detection rate of M gene was 30.0% (6/20), which was mainly CTX-M-9 (4/6). The prevalence of CTX-M gene in hospital-acquired strains was 50.0% (10/20), of which CTX-M-9 accounted for 7/10. The susceptibility of hospital-acquired strains to cefuroxime, cefazolin, ceftriaxone, ciprofloxacin, levofloxacin, trimethoprim, sulfamethoxazole, nitrofurantoin and amikacin was significantly lower Among community-acquired strains (P <0.05). Conclusion The resistance rate of acquired urethral pathogenic Escherichia coli to some antibacterials in Zhejiang province was significantly higher than that of community-acquired strains. The CTX-M-9 gene of ESBLs was the main factor.