产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌blaCTX-M基因的检测

目的了解产CTX-M型超广谱β-内酰胺酶 (ESBLs) 大肠埃希菌和肺炎克雷伯菌在深圳市人民医院的分布情况.方法应用美国国家临床实验室标准化委员会(NCCLS)推荐的表型确证试验,从2000年6月～2003年8月该院临床标本分离株中筛选出不重复的产ESBLs菌株215株,其中大肠埃希菌151株,肺炎克雷伯菌64株,应用聚合酶链反应(PCR)检测所有产ESBLs株的bla(CTX-M)基因.结果 PCR结果显示,大肠埃希菌bla(CTX-M)基因阳性率为92.1%(139/151),肺炎克雷伯菌的阳性率为65.6%(42/64).bla(CTX-M)基因阳性菌株主要来源于临床送检尿和痰标本,并广泛分布于20多个临床科室.结论该院临床分离的大肠埃希菌和肺炎克雷伯菌产生的ESBL大多数为CTX-M型,该类酶广泛分布于各临床科室,需引起重视.

Detection of blaCTX-M gene in Escherichia coli and Klebsiella pneumoniae which producing ESBLs

Objective To understand the distribution of Escherichia coliand Klebsiella pneumoniae which producing CTX-M type ESBLs in our hospital. Methods From the clinical isolates between June 2000 and August 2003, 151 Escherichia coli and 64 Klebsiella pneumoniae ESBLs-producing strains were determined by phennotyic confirmatory test according to NCCLS guide. The presence bla(CTX-M) gene was confirmed by specific PCR assays. Results 92.1% of the Escherichia coli or 65.6% of the Klebsiella pneumoniae were showed carried bla(CTX-M) gene.Most CTX-M strains were isolated from urine or sputum,and they were widely distributed to more than 20 clinical departments.Conclusions Most of ESBLs in our hospital were CTX-M they were widely distributed to many clinical departments.