Enterobacteriaceae Producing β-lactamase Resistance And Caused By Drug-resistant Infectious Disease Research

Objective:To study the Dali region of Enterobacteriaceae producingβ-lactamases and bacterial resistance caused by infectious diseases and the prevalence of blaTEM-1D resistance gene, to guide the clinical application of antibiotics.Methods:(1) Of Enterobacteriaceae producingβ-lactamase resistant species collection, identification and qualitative detection of enzyme production strains:from Dali University Hospital, the Hospital of Dali, Dali City, First Hospital of selected clinical isolates of intestinal Bacillus Division producing P-lactamase resistant (at least one kind of (3-lactam antibiotics), with automated microbial identification system (VITEK) identified to species. Then post thiophene cephalosporin filter paper method (nitrocefin test) on the detection of bacteria per plant whether theβ-lactamase producing strains. Bacteria per plant species in the trial after the switch to the 2ml EP filled with sheep blood tubes were incubated 16 to 20 hours standby placed-70℃refrigerator. (2) antimicrobial susceptibility test:MIC method (broth microdilution method) of the resistant selected eight kinds ofβ-lactam antibiotics susceptibility test, statistical multi-drug resistance, resistance rates to antibiotics and how strains dominated. (3) blaTEM-1D resistance gene detection (PCR method):Extraction of drug-resistant strains of plasmid DNA, design of good primers target DNA, using agarose gel electrophoresis, labeled with Mark Expenditure and amplicon size (bp length), then amplified by standard agarose gel electrophoresis analysis of PCR amplicon size, to detect whether it contains blaTEM-1D resistance gene. And the ratio of statistical blaTEM-1D resistance gene. (4) due to infectious diseases:access to medical records, were retrospectively analyzed samples from bacteria and clinical disease.Results and ConcIlisions:(1) The group of test bacteria Escherichia Enterobacteriaceae 64 (all Escherichia coli), Klebsiella spp 41 (lung grams of 39, acid g 2), intestinal sp 16 (4 agglomerate intestine, intestinal gas production 1),8 strains of Serratia (7 strains liquefied sand, clayey sand 1 strain), Salmonella spp 3 (Bacillus paratyphi 2,1 strain of Salmonella typhi), Shigella 2 (Shigella bacteria 2),1 strain of Proteus (Proteus mirabilis 1), Morgan genus 1 (Mohs Morgan strains 1 strain), Yersinia spp 1 (colon pestis 1).9 spp, 14 strains, a total of 137. Citrobacter is a lack of specimens. The isolation rate of E. coli, followed by Klebsiella. Dali University Hospital 52, Hospital 33 in Dali, Dali City, First Hospital 52.β-lactamase test was positive (red) reaction, both enzyme production strains. (2) multiple drug resistance in this experiment seriously, more than double resistance accounted for 88.7%. The following order:triple resistance 19.0%,18.2% double resistance, resistance 14.6% Five or six heavy resistance 12.4%,11.7% quadruple resistance, resistance 11.7% Seven, eight heavy resistance 1, accounting for 0.7%. Triple drug most serious, at least eight heavy resistance. Various P-lactam antibiotic resistance rates, the high resistance to ampicillin and cefuroxime in this area is no longer used. Thailand to resistance rates, in the region are still valid. The other 5 have different degrees of resistance, but with selective use of drug susceptibility tests still valid. (3) The group blaTEM-1D resistance gene test positive 62, the ratio was 45.3%(62/137).31 strains of Escherichia coli, the rate was 22.7% (31/137); 18 strains of Klebsiella pneumoniae, the rate was 13.2%(18/137). Other less. blaTEM-1D resistance gene in this region, the level of communication exists between various hospitals and hospital vertical transmission. (4) The test specimens from a wide range, sputum, urine, feces, blood, pus, body surface secretions, bile, ascites, pleural effusion, cerebrospinal fluid, intravenous catheters, swabs and so on. Mainly in sputum samples (43.1%), urine (20.4%), with the main cause respiratory (51.8%), urinary (20.4%) infections, mainly E. coli bacteria (46.7%), Klebsiella Bacteria (29.9%). Cause blood infections is E. coli, the central nervous system infections are Klebsiella pneumonia, trauma and surgical infections is E. coli. Respiratory tract infections is Escherichia coli and Klebsiella. Gastrointestinal infection inflammation Klebsiella, Shigella, E. coli, marcescens. Urinary tract infections is E. coli. The test Enterobacteriaceae closely with clinical departments, but primarily of Respiratory Medicine, ICU, urinary medicine, general surgery, etc.. Respiratory Medicine by Klebsiella, Escherichia coli; urinary medicine in Escherichia coli; ICU with E. coli, K. pneumoniae was mainly due to the Section of patients in critical condition, body immunocompromised, ventilator, long-term use of antibiotics led to a large number of flora caused by infection. General surgery in Escherichia coli, mainly purulent infection. Another feature of this experiment are:1. Proteus mirabilis, Morgan bacteria often leads to urinary tract infections, colon, Yersinia pestis infection in the digestive tract pathogens, this set of experiments found that P. mirabilis, Mount Morgan's bacillus, colon Ye Wilson bacteria causing respiratory tract infections each one, Less.2. Klebsiella frequently cause respiratory, urinary tract and wound infections, often caused marcescens pneumonia, urinary tract infections, sepsis and infection after surgery, the experiments also found that 2 strains of Klebsiella, marcescens 1 strains cause gastrointestinal infection, a rare situation. Due to small number of cases, it is not for further analysis.