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目的分析普外科患者切口感染大肠埃希菌的耐药性并检测耐药基因,以期为临床抗感染治疗提供参考。方法收集2014-2016年131例本院普外科诊治的切口感染患者临床资料,从切口分泌物中分离大肠埃希菌。采用全自动细菌鉴定仪鉴定菌株。采用K-B法检测大肠埃希菌的耐药情况,PCR扩增检测菌株的耐药基因。结果共分离出16株大肠埃希菌,对诺氟沙星、氧氟沙星、环丙沙星、阿米卡星、庆大霉素和妥布霉素的耐药率分别为18.75%、12.50%、6.25%、12.50%、43.75%和56.25%。PCR检测结果显示,aac(3)-II基因检测阳性率为50.00%、aac(6’)-I基因阳性率为12.50%、qnr基因阳性率为18.75%、parC基因阳性率为6.25%、gyrA基因阳性率为6.25%。结论大肠埃希菌对多数常见药物均产生了耐药性,但对加替沙星仍敏感;耐药基因分布与大肠埃希菌耐药性有直接关系,及时监测耐药基因分布情况对控制大肠埃希菌耐药性具有重要意义。
Objective To analyze the drug resistance of Escherichia coli in incisional wound infection in general surgery patients and to detect the drug resistance genes in order to provide a reference for clinical anti-infective therapy. Methods Clinical data of 131 incisional wound infection patients in our hospital from 2014 to 2016 were collected. Escherichia coli was isolated from incisional secretions. The use of automatic bacterial identification instrument identified strains. The K-B method was used to detect the drug resistance of Escherichia coli, and the drug resistance genes of the strains were detected by PCR. Results A total of 16 strains of Escherichia coli were isolated and the drug resistance rates to norfloxacin, ofloxacin, ciprofloxacin, amikacin, gentamicin and tobramycin were 18.75% 12.50%, 6.25%, 12.50%, 43.75% and 56.25%. The positive rate of aac (6) - I gene was 12.50%, the positive rate of qnr gene was 18.75%, the positive rate of parC gene was 6.25%, gyrA Gene positive rate was 6.25%. Conclusion Escherichia coli is resistant to most common drugs, but sensitive to gatifloxacin. The distribution of drug resistance genes is directly related to the drug resistance of Escherichia coli, and timely monitoring the distribution of drug resistance genes to control Escherichia coli resistance is of great significance.