于汶. 某社区医院感染患者常见致病菌耐药性与整合子分布关系初步分析[J]. 疾病监测, 2008, 23(12): 742-744. DOI: 10.3784/j.issn.1003-9961.2008.12.742
引用本文: 于汶. 某社区医院感染患者常见致病菌耐药性与整合子分布关系初步分析[J]. 疾病监测, 2008, 23(12): 742-744. DOI: 10.3784/j.issn.1003-9961.2008.12.742
YU Wen. Relationship between the drug resistance and the distribution of integrons of common pathogens isolated in a community hospital[J]. Disease Surveillance, 2008, 23(12): 742-744. DOI: 10.3784/j.issn.1003-9961.2008.12.742
Citation: YU Wen. Relationship between the drug resistance and the distribution of integrons of common pathogens isolated in a community hospital[J]. Disease Surveillance, 2008, 23(12): 742-744. DOI: 10.3784/j.issn.1003-9961.2008.12.742

某社区医院感染患者常见致病菌耐药性与整合子分布关系初步分析

Relationship between the drug resistance and the distribution of integrons of common pathogens isolated in a community hospital

  • 摘要: 目的 分析某社区医院感染常见致病菌对临床常用抗菌药物的耐药性与整合子的关系,为合理应用抗生素提供参考。方法 经VITEK?AMS鉴定仪鉴定分离株,用K?B纸片测试细菌对临床常用抗生素耐药性;双纸片协同法筛选?内酰胺酶(ESBLs)阳性菌;通过特异引物聚合酶链反应(PCR)扩增调查整合子分布。结果 本社区医院分离的76株感染菌以G-菌为主(61株),其中大肠埃希菌(24株)和肺炎克雷伯菌(19株)多见;G+菌(15株)主要为表皮葡萄球菌(10株)。检出了Ⅰ、Ⅱ类整合子,前者阳性率44.7%(34/76),主要分布于G-菌中,且于肺炎克雷伯菌中最多,占检出整合子的47.1%(16/34)。后者检出较少,阳性率仅6.5%(5/76),但也主要分布在肺炎克雷伯菌中(3株)。多数分离菌(40.0%以上)对常用抗生素耐药,整合子及ESBLs均阳性的菌株呈多重耐药。肺炎克雷伯菌及大肠埃希菌对?内酰胺类药耐药最为突出,耐药率分别高达46.0%(11株)和90.0%(17株),其次为喹诺酮、氨基糖苷、氯霉素类药物,耐药率平均也在49.0%以上。结论  本社区医院分离的致病菌以G-菌的肺炎克雷伯菌及大肠埃希菌为主,主要呈Ⅰ类整合子分布。多数分离株对临床常用抗菌素表现耐药,且耐药性与整合子的存在相关。

     

    Abstract: Objective To analyze the relationship between integrons distribution and antibiotic resistance of common pathogens isolated in a community hospital and to provide evidence for appropriate administration of antibiotics. Methods VITEK-AMS was employed for identification of isolates, seventy six isolates were tested for antibiotic resistance by Kirby - Bauer methods. ESBLs positive bacteria were selected by double-disk synergy test and the distribution of integrons were detected by PCR. Results A total of 76 strains were isolated in the community hospitals, the majority of which (61) were Gram-negative bacteria, predominated by IEscherichia coli/I (24) and IKlebsiella pneumoniae/I (19). Most of the gram positive bacteria (15) were Staphylococcus epidermidis (10). Among the 76 strains, ClassⅠand Ⅱ integrons were detected. The positive rate of ClassⅠintegron was 44.7% (34/76), which mainly distributed in Gram-negative bacteria, and most commonly in IKlebsiella pneumoniae/I, accounting for 47.1% of all the detected integrons (16/34). Class Ⅱ integrons was detected in 5 strains of isolates with the positive rate of 6.5% (5/76), mainly distributing in IKlebsiella pneumoniae/I (3),too. More than 40.0% of the isolates were resistant to commonly used antibiotics, and the isolates with integrons and ESBLs showed multi-drug resistance. Most of strains of IEscherichia coli/I and IKlebsiella pneumoniae/I were resistant to -lactams with the resistant rates of 46.0% (11) and 90.0% (17), respectively, to which followed by quinolone, aminoglycoside, and amphenicols, with the average resistance rate of above 49%.Conclusion The predominant strains isolated in the community hospital were Gram negative IEscherichia coli/I and IKlebsiella pneumoniae/I, mostly presenting with class Ⅰ integron distribution. Most isolates were resistant to commonly used antibiotics, and the drug resistance was correlated with the presence of integrons.

     

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