本文選題：三代頭孢耐藥　切入點：大腸埃希菌　出處：《基因組學(xué)與應(yīng)用生物學(xué)》2016年07期 　論文類型：期刊論文

【摘要】：為了探究血流感染中耐三代頭孢大腸埃希菌(third-generation-cephalosporin-resistant Escherichia coli,3GCREco)的分子流行病學(xué)特點及感染危險因素,最終為臨床用藥和感染防控提供理論依據(jù),我們在重慶醫(yī)科大學(xué)附屬第一醫(yī)院2013年1月至2015年12月期間,選取了120例耐三代頭孢大腸埃希菌血流感染患者作為耐藥組,等比例選取120例三代頭孢敏感大腸埃希菌血流感染患者為敏感組。采用VITEK2檢測藥敏情況、聚合酶鏈反應(yīng)(PCR)擴增耐藥基因、脈沖場凝膠電泳(PFGE)進行流行病學(xué)調(diào)查,統(tǒng)計相關(guān)病例資料進行危險因素分析。我們的研究結(jié)果發(fā)現(xiàn)耐藥組120株菌株對多數(shù)頭孢類抗生素表現(xiàn)耐藥,對哌拉西林/他唑巴坦多表現(xiàn)敏感,對碳青霉烯類均敏感;耐藥組中超廣譜β類酰胺酶(ESBLs)基因占65.00%(78/120);Ⅰ類整合子基因占14.17%(17/120);氨基糖苷類基因和喹諾酮類基因檢出率較低,分別占5.83%(7/120)和3.33%(4/120);PFGE結(jié)果顯示菌株間不存在克隆相關(guān)性;危險因素分析結(jié)果顯示尿路感染(OR=2.222;p=0.029)、感染前手術(shù)史(OR=3.063;p=0.014)、頭孢類抗生素使用史(OR=2.301;p=0.036)是其獨立危險因素。這些結(jié)果提示我們血流感染中耐三代頭孢大腸埃希菌ESBLs基因檢出率高,引起的血流感染多與頭孢類抗生素使用史、尿路感染及手術(shù)史相關(guān),為此,我們建議臨床工作者合理使用抗生素,減少侵入性操作,同時加強醫(yī)院感染監(jiān)管工作,從而減少耐藥菌的傳播與流行。
[Abstract]:In order to investigate the molecular epidemiological characteristics and infection risk factors of third-generation-cephalosporin-resistant Escherichia (3GCREcoC) in blood stream infection, it can provide theoretical basis for clinical use of drugs and prevention and control of infection. During the period from January 2013 to December 2015 in the first affiliated Hospital of Chongqing Medical University, 120 patients with third generation resistant Escherichia coli infection were selected as drug resistant group. VITEK2 was used to detect drug sensitivity, polymerase chain reaction (PCR) was used to amplify the drug resistance gene, and pulsed field gel electrophoresis (PFGE) was used to investigate the epidemiology. Our results showed that 120 strains of resistant group showed resistance to most cephalosporins, sensitive to piperacillin / tazobactam, and sensitive to carbapenems. In the drug resistant group, the percentage of ESBLsof extended-spectrum 尾 -aminase (ESBLs) gene was 65.00 / 120; the proportion of class 鈪，

本文編號：1637536