Analysis Of Drug Resistance Of β-lactamase-producing Escherichia Coli Containing SHV-genotype And Its Correlation With Infectious Diseases In Baoshan

ObjectiveTo study the detection rate, the specimen origin, the distribution of clinicaldepartments and the drug resistance of the beta lactamase-producing Escherichia coliin Baoshan,and to analyze their relationship between E Coli and the infectiousdiseases and the clinical distributions of drug-resistant gene SHV type, so as toprovide basis for clinical rational use of antibiotics.Method1. The collection and the identification of beta lactamase-producing Escherichia coli:the clinical isolates of beta lactamase-producing Escherichia coli were collected froma hospital in Baoshan City (the same parts of the same patients detected the bacteriado not repeat count), and identified by using Compact automatic analyzer (VITEK).2. Detection of beta lactamase-producing Escherichia coli: each bacterial strain wasdetected using rapid detection test method which can detect beta lactamase.3. Analysis of drug resistance of beta lactamase-producing Escherichia coli: MICvalues of8kinds of antibiotics were detected using the broth microdilution method toanalyze their drug resistance. 4. Molecular biological detection: target DNA fragments were amplified bypolymerase chain reaction (PCR) and detected by agarose gel electrophoresis.5. The relationship between beta lacamase-producing E.coli and infectious diseaseswas analyzed retrospectively: clinical records were reviewed retrospectively toanalyze clinical specimen source, distribution of beta lactamase producingEscherichia coli.Result1. Among230strains of infectious specimens collected in a hospital in2011,92strains of Escherichia coli were detected accounting for40%(92/230).2.82strains of beta lactamase-producing Escherichia coli were detected. Thedetection rate was89%(82/92).3. Among82strains of beta lactamase-producing Escherichia coli, urine samples werethe largest number followed by venous blood samples and secretions samples.Thedetectiong rates of specimen source were ranked from high to low: the urine63.4%(52/82), venous blood13.4%(11/82), secretion7.3%(6/82); the sputum4.9%(4/82); the puncture4.9%(4/82), the drainage3.7%(3/82), the pus2.4%(2/82).4. Escherichia coli were highly resistant to multiple antibiotics,whereas sensitive toimipenem.The drug resistance rates were ranked from high to low as follows:ampicillin(92.4%), cotrimoxazole (79.2%), ceftazidime (58.5%), levofloxacin(52.4%), ampicillin sulbactam sodium (51.2%), nitrofurantoin (15.9%),and Amikacin(3.6%).5. Dual drug resistance accounted for30.4%(25/82);triple drug resistance43.9%(36/82), quadruple drug resistance7.3%(6/82); quintuple drug resistance1.2%(1/82).6. PCR results showed that among82strains of beta lactamases-producingEscherichia coli5strains were SHV genotypes accounting for6.1%(5/82). 7. Medical records were analyzed retrospectively.Beta lactamase-producingEscherichia coli and SHV type strains which mainly cause urinary system infectionwere mainly isolated from urine specimens.ConclusionEscherichia coli is the main opportunistic pathogen in hospital infection.It can causemultiple organ infection, especially urinary system infection. The vast majority ofEscherichia coli can produce beta lactamase resulting in generally resistance to manyantibiotics, however is sensitive to the carbapenem. The SHV genotype is in lowpercentage among beta lactamase-producing Escherichia coli in the hospital.Therefore Escherichia coli should be detected and monitored more strongly and themanagement of antibiotics should be standardized in order to control the occurrenceand spread of drug-resistant bacteria.