【摘要】：研究背景: 超廣譜β-內(nèi)酰胺類抗生素(如:頭孢噻肟、頭孢曲松、頭孢他啶、氨曲南、頭孢泊肟)引入臨床應(yīng)用后不久,歐洲的德國(guó)就在1983年就首次報(bào)道分離出SHV-2型超廣譜β-內(nèi)酰胺酶(extended spectrum beta-lactamases,ESBLs),隨后全世界許多地方不斷有新的ESBLs檢出(具體種類、氨基酸位點(diǎn)改變及等電點(diǎn)見http://www.lahey.org/studies/webt.htm)。 超廣譜β-內(nèi)酰胺酶(extended spectrum beta-lactamases,ESBLs)是由質(zhì)粒介導(dǎo)的水解多種β-內(nèi)酰胺類抗生素的一類酶。它主要由革蘭陰性桿菌產(chǎn)生。產(chǎn)ESBLs的菌株耐藥問題已經(jīng)成為當(dāng)前全球最重要的醫(yī)院內(nèi)耐藥問題之一。 自從ESBLs被報(bào)道以來,在世界各地引起了廣泛傳播流行。其部分原因是因?yàn)槿鄙倏煽康臋z測(cè)方法,人們往往是在第三代頭孢菌素治療失敗后,才意識(shí)到可能有ESBLs細(xì)菌的存在。早期檢測(cè)ESBLs,對(duì)控制其流行和傳播,尤為重要。而且,由于各地區(qū)流行的基因型不同而存在耐藥性和檢測(cè)底物的地區(qū)差別。因此了解肺炎克雷伯菌和大腸埃希菌的最佳檢測(cè)底物及耐藥性特點(diǎn),有利于防止產(chǎn)ESBLs菌株的區(qū)域性流行,并指導(dǎo)臨床治療,以免延誤病情和造成浪費(fèi)。 鑒于安徽省尚無大范圍的調(diào)查研究資料,我們對(duì)安徽省蚌埠地區(qū)四家較大醫(yī)院臨床標(biāo)本中分離的肺炎克雷伯菌和大腸埃希菌的耐藥性及ESBLs的產(chǎn)生情況及產(chǎn)ESBLs菌株的耐藥性進(jìn)行了研究,并對(duì)產(chǎn)ESBLs的肺炎克雷伯菌和大腸埃希菌進(jìn)行了耐藥基因的初步分型。 目的: 了解安徽省蚌埠地區(qū)產(chǎn)ESBLs肺炎克雷伯菌和大腸埃希菌檢測(cè)的最佳底物。
[Abstract]:Background: Extended-spectrum 尾 -lactam antibiotics (such as cefotaxime, ceftriaxone, ceftazidime, aztreonam, cefopoxime) were introduced into clinical practice shortly after their clinical application. The SHV-2 type extended spectrum 尾 -lactamases (extended spectrum beta-lactamases ESBLs were first reported in Germany in 1983, followed by new ESBLs detection in many parts of the world (specific species, amino acid site changes and isoelectric point (http://www.lahey.org/studies/webt.htm). Extended-spectrum 尾 -lactamases (extended spectrum beta-lactamases (ESBLs) is a kind of enzyme mediated by plasmids to hydrolyze a variety of 尾 -lactam antibiotics. It is mainly produced by gram-negative bacilli. Drug resistance of ESBLs-producing strains has become one of the most important hospital drug-resistance problems in the world. Since ESBLs was reported, it has caused widespread popularity around the world. This is partly due to the lack of reliable detection methods, and it is not until the third generation cephalosporins fail that they are aware of the presence of ESBLs bacteria. Early detection of ESBLsis particularly important to control its prevalence and spread. Moreover, drug resistance and substrate detection vary from region to region due to different genotypes. Therefore, understanding the best detection substrate and drug resistance characteristics of Klebsiella pneumoniae and Escherichia coli is helpful to prevent the regional prevalence of ESBLs producing strains, and to guide clinical treatment so as to avoid delay and waste. In view of the lack of extensive investigation and research data in Anhui Province, We studied the drug resistance of Klebsiella pneumoniae and Escherichia coli isolated from clinical specimens of four large hospitals in Bengbu, Anhui Province, and the production of ESBLs and the drug resistance of ESBLs producing strains. ESBLs producing Klebsiella pneumoniae and Escherichia coli were genotyped. Objective: to investigate the best substrate for detection of Klebsiella pneumoniae and Escherichia coli in Bengbu, Anhui province.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R181.3

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