碳青霉烯耐药大肠埃希菌的药物敏感性、耐药基因及多位点序列分型分析*

doi:10.3969/j.issn.1671-2587.2020.06.018

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (6): 633-637.DOI: 10.3969/j.issn.1671-2587.2020.06.018

碳青霉烯耐药大肠埃希菌的药物敏感性、耐药基因及多位点序列分型分析^*

谢晖, 曹小利, 陈雨欣, 周万青, 沈瀚

210008 南京大学医学院附属鼓楼医院检验科

收稿日期:2020-07-04 出版日期:2020-12-20 发布日期:2021-01-18
通讯作者: 沈瀚,男,主任检验师,硕士,主要从事医院感染病原菌的耐药机制研究,(E-mail)shenhan10366@sina.com。
作者简介:谢晖(1991-),女,检验技师,硕士研究生,主要从事微生物检验工作,(E-mail)xiehui121391@163.com。
基金资助:
*本课题受国家自然科学青年基金(No.81902124)、南京市卫生局“十三五”青年卫生人才培养工程(第二层次)(No.QRX17059)资助

Analysis on the Drug Susceptibility,Carbapenem Resistance Determinants and Multi-locus Sequence Types of Carbapenem Resistant Escherichia coli

XIE Hui, CAO Xiao-li, CHEN Yu-xin, et al

Department of Laboratory Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008

Received:2020-07-04 Online:2020-12-20 Published:2021-01-18

摘要/Abstract

摘要： 目的分析碳青霉烯耐药大肠埃希菌的药物敏感性、碳青霉烯耐药基因的分布及多位点序列分型。方法收集连续非重复分离碳青霉烯耐药大肠埃希菌11株,使用Vitek 2 Compact仪器测定细菌的药物敏感性;PCR和DNA测序技术检测碳青霉烯耐药基因;多位点序列分型方法对细菌进行序列分型;接合实验分析bla_NDM基因的转移性。结果碳青霉烯耐药大肠埃希菌对临床常用的多种抗菌药物耐药;11株碳青霉烯耐药大肠埃希菌中,9株携带bla_NDM基因,其中有2株细菌同时携带bla_KPC基因;多位点序列分型显示,9株细菌检出7种序列分型,分别为ST167(n=3)、ST6349(n=1)、ST361 (n=1)、ST6335(n=1)、ST617(n=1)、ST7016(n=1)和ST354(n=1);接合实验发现,bla_NDM基因均可转移,但bla_NDM基因的转移不伴有bla_KPC的转移。结论 NDM的产生是大肠埃希菌对碳青霉烯耐药的主要原因,其容易在细菌中播散,需要进一步加强感染的预防与控制措施。

关键词: 大肠埃希菌, 碳青霉烯耐药, 多位点序列分型, bla_NDM

Abstract: Objective To analyze the drug susceptibility,carbapenem resistance determinants and multi-locus sequence types of carbapenem resistant Escherichia coli.Methods Carbapenem-resistant E.coli isolates collected from our hospital were analyzed for the susceptibilities by Vitek 2 Compact.Detection of carbapenem resistance genes was performed by PCR and DNA sequencing,Multi-locus sequence typing was used to analyze the sequence types of bacteria.The transferability of bla_NDM gene was analyzed by conjugation experiment.Results Carbapenem-resistant E.coli were resistant to most of the commonly used antibiotics in clinical therapy.Nine out of 11 carbapenem resistant E.coli isolates were found to carry bla_NDM gene,and two isolates of them were found to carry bla_KPC gene.The results of multilocus sequence typing showed that 11 E.coli isolates were assigned into 7 sequence types (STs),which were ST167(n=3),ST6349(n=1),ST361(n=1),ST6335(n=1),ST617(n=1),ST7016(n=1) and ST354(n=1).The results of conjugation test showed that bla_NDM gene could be transferred,without bla_KPC gene being co-transferred.Conclusion The production of NDM is the main mechanism of E.coli conferring resistance to carbapenem,which is easy to spread among bacteria,infection control measures should therefore be further strengthened.

Key words: Escherichia coli, Carbapenem resistance, Multi-locus sequence typing, bla_NDM

中图分类号:

R446.5

谢晖, 曹小利, 陈雨欣, 周万青, 沈瀚. 碳青霉烯耐药大肠埃希菌的药物敏感性、耐药基因及多位点序列分型分析^*[J]. 临床输血与检验, 2020, 22(6): 633-637.

XIE Hui, CAO Xiao-li, CHEN Yu-xin, et al. Analysis on the Drug Susceptibility,Carbapenem Resistance Determinants and Multi-locus Sequence Types of Carbapenem Resistant Escherichia coli[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2020, 22(6): 633-637.

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碳青霉烯耐药大肠埃希菌的药物敏感性、耐药基因及多位点序列分型分析^*

Analysis on the Drug Susceptibility,Carbapenem Resistance Determinants and Multi-locus Sequence Types of Carbapenem Resistant Escherichia coli

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